Coverage

id

string The identifier of this coverage record

beneficiary

Reference(Patient) required
The person who receives the benefit for the coverage

In Halaxy, if there is noclaimant, the patient is the default beneficiary. See article about Medicare claimants.

See also: Patient

subscriber

Reference(Patient) required
The person receiving the treatment under the coverage

See also: Patient

subscriberID

string
The patient's claim details (e.g. membership number, card number, reference number)

dependent

string
An individual reference number (IRN) on the membership card, typically a single digit number before the cardholder's name

period

period
The time period when the coverage was valid

start: date
end: date

status

enum
The status of the coverage

"active" "cancelled"

payor

Reference(Organization) or Reference(Patient) required
The issuer of the coverage policy - if Organization, this is the funder (FD) ID.

See also: Patient, Organization

coverage patient anonymous

HALAXY API EXTENSION
Indicates whether the patient's name is anonymized or displayed on invoices where this coverage is used.

If true, the patient's name is anonymized on the invoice.
If false, the patient's real name is displayed on the invoice.

coverage payer

HALAXY API EXTENSION
Determines who is billed on the invoice. For invoices billed to third-party organizations, you can also determine how invoices are generated for fees associated with the coverage funder.

code / display
29 - "Patient"
30 - "Organisation (new invoice)"
31 - "Organisation (existing invoice, same patient)"
32 - "Organisation (existing invoice, any patient)"

Note: In Halaxy, this refers to the Payer field in the Funder settings. See article:Guide to funders

coverage organisation

HALAXY API EXTENSION

Reference(Organization)
The paying organization for this coverage

"reference": "/main/Organization/OG-12345678"
"type": "Organization"

See also: Organization

attachments

File attachments to the referral (POST only)

contentType enum required
The format of the file attachment
Supported formats: application/msword application/vnd.ms-excel application/vnd.openxmlformats-officedocument.wordprocessingml.document application/vnd.openxmlformats-officedocument.spreadsheetml.sheet application/pdf image/jpeg image/png

data required
File must be encoded into base64 format
Maximum file size: 20MB

title string required
The file name