Purpose
Correctly identify the patient's plan — carrier + group + variant — before processing any verification or claim.
Identification hierarchy
| Level | Data | How to obtain |
|---|---|---|
| 1 | Carrier (Insurance) | Patient card + logo |
| 2 | Subscriber ID | Card |
| 3 | Group Number | Card (identifies specific plan within carrier) |
| 4 | Plan Type (PPO/HMO/etc) | System dropdown + confirm with carrier |
| 5 | Plan Variant | Detected during verification (atypical frequencies, custom rules) |
Naming convention
BrandaCare format for plan identification:
[CarrierID]_[GroupNumber]_[PlanType] Example: 60061_12345_PPO
Required validation
- Confirmed Subscriber ID
- Plan Type selected from dropdown (not free-text)
- Supervisor approval signature
- Group Number documented
Stub: Flesh out with dropdown screenshots + actual internal dashboard workflow.