Healthcare Member Details schema field group

Last update: 2023-12-15
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Healthcare Member Details is a standard schema field group for the XDM Individual Profile class that captures details of a person that has or will receive medical service or care, such as contact information, primary care physician, and plan information.

Field group structure

Property Data type Description
billingAddress Postal address The person’s billing address.
faxPhone Phone number The person’s fax phone number.
homeAddress Postal address The person’s home address.
homePhone Phone number The person’s home phone number.
mailingAddress Postal address The person’s mailing address.
memberDetails Object An object that contains detailed information about the person’s healthcare-related attributes and relationships. See the subsection below for more information on the object’s structure.
mobilePhone Phone number The person’s mobile phone number.
person Person An individual actor, contact, or owner related to the person’s healthcare membership.
personalEmail Email address The person’s personal email address.
shippingAddress Postal address The person’s shipping address.

memberDetails

memberDetails is an object that contains detailed information about the person’s healthcare-related attributes and relationships. The structure of memberDetails is described below.

memberDetails structure

Property Data type Description
emergencyContact Object Captures the following emergency contact details for the person:
  • fullName: (String) The full name of the emergency contact.
  • phone: (String) The phone number for the emergency contact.
  • relationshipToMember: (String) The emergency contact’s relationship to the person.
medications Array of objects Lists the details of current and past medications associated with the person. Each array item is an object that captures the following details:
  • refillLocation: (Postal address) The refill location for the medication.
  • ID: (String) Medication ID.
  • isCurrent: (Boolean) Indicates whether the medication is current or past.
  • numberOfRefills: (Integer) The number of refills prescribed by the provider of this medication.
  • startDate: (DateTime) The date on which the person began taking the medication.
multipleBirth Object Captures details related to multiple births:
  • isMultipleBirth: (Boolean) Indicates whether the person gave multiple births.
  • multipleBirthNumber: (Integer) The number of babies born if isMultipleBirth is true.
plans Array of objects Lists the details of current and past medical plans associated with the person. Each array item is an object that captures the following details:
  • coverageEndDate: (DateTime) The date on which the plan coverage ends.
  • coverageStartDate: (DateTime) The date on which the plan coverage starts.
  • isActive: (Boolean) Indicates whether the plan is active.
  • planId: (String) The plan ID.
primaryCarePhysicians Array of objects Lists the details of primary care physicians associated with the person. Each array item is an object that captures the following details:
  • endDate: (DateTime) The date on which the primary care physician ended care for the person.
  • fullname: (String) The full name of the physician.
  • providerId: (String) A unique identifier for the physician.
  • startDate: (DateTime) The date on which the primary care physician started care for the person.
specialists Array of objects Lists the details of healthcare specialists associated with the person. Each array item is an object that captures the following details:
  • fullname: (String) The full name of the specialist.
  • providerId: (String) A unique identifier for the specialist.
  • specialty: (String) The specialty of the provider (such as anesthesiology, urology, radiology, dermatology, and so on).
beneficiaryRelationship String The beneficiary relationship to the healthcare member if the person is a dependent (examples include self, spouse, child, and so on).
billingAccountID String A unique identifier for the person’s billing account.
dateAgeCollected DateTime The date the person’s age was collected.
deceasedDate DateTime The date the person died if they are deceased.
isDeceased Boolean Indicates whether the person is deceased.
isDependent Boolean Indicates whether the person is a dependent.
nationality String The legal relationship between the person and their state, represented using the ISO 3166-1 Alpha-2 code.
preferredAvailability String The person’s preferred day and time availability for an appointment.
primaryMemberID String A unique identifier of the primary subscriber if the person is a dependent.

For more details on the field group, refer to the public XDM repository:

Refer to the industry schema documentation for more information on how this field group can be used to serve common healthcare industry use cases.

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