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Configure Data Streams for Member Coverage Objects
To define the member coverage data ingested into Data 360, configure member coverage data streams.
Required Editions
| Available in: Lightning Experience |
| Available in: Enterprise, Performance, and Unlimited Editions with the Agentforce for Health Cloud and Agentforce Employee Agent add-on licenses |
| User Permissions Needed | |
|---|---|
| To access Data Cloud Setup: | System admin profile OR Data Cloud Architect permission set |
| To edit a data stream: | Data Cloud Architect permission set |
Data 360 stores member plan and coverage details in the Individual, Member Plan, Coverage Benefit, Coverage Benefit Item, Coverage Benefit Item Limit, and Care Limit Type Data Model Objects (DMOs). The member coverage data graph helps map the member plan and coverage data with an individual record. To make sure that member coverage subagent can access the correct information, map fields for member coverage DMOs in data streams.
- Turn on Data 360.
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Configure data streams for the DMOs that support member coverages.
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Configure the data stream for the Individual object.
Field Data Type Individual ID Text - Primary Key First Name Text Last Name Text Birth Date Date External Record ID Text Age Number Gender Text -
Configure the data stream for the Member Plan object.
NoteIf the Member Plan DMO Member Individual and Subscriber Individual fields are missing from your org, you must wait for the org update coming in late March‘26.
Field Data Type Member Plan ID Text Member Individual Text Name Text Subscriber Individual Text Member Number Text Group Number Text Plan Status Text Plan Type Text Effective From Date Date Effective To Date Date Relationship To Subscriber Text Primary Care Physician Name Text Healthcare Payer Network Text -
Configure the data stream for the Coverage Benefit object.
Field Data Type Coverage Benefit Text - Primary Key Member Plan Text Name Text Coverage Type Text Is Active Boolean Benefit Period Start Date Date Benefit Period End Date Date In-Network Indv Ded Limit Amt Number In-Network Individual Ded Amt Number In-Network Indv Ded Rmn Amt Number In-Network Family Ded Limit Amt Number In-Network Indv OOP Limit Amt Number In-Network Family OOP Limit Amt Number In-Network Indv OOP Amt Number In-Network Indv OOP Rmn Amt Number Out-of-Network Indv Ded Limit Amt Number Out-of-Network Family Ded Limit Amt Number Out-of-Network Indv OOP Limit Amt Number Out-of-Network Family OOP Limit Amt Number Primary Care Copay Amount Number Specialist Consultation Copay Amount Number Emergency Treatment Copay Amount Number Urgent Care Copay Amount Number In Network Coinsurance Percentage Number Out of Network Coinsurance Percentage Number Deductible Notes Text Copay Note Text Coinsurance Note Text Out of Pocket Payment Notes Text Benefit Note Text Disclaimer Text -
Configure the data stream for the Coverage Benefit Item object.
Field Data Type Coverage Benefit Item ID Text - Primary Key Coverage Benefit Text Name Text Benefit Category Text Is Active Boolean Coverage Level Text Service Type Text Is In Plan Network Boolean Is Preauthorization Required Boolean In Network Coverage Description Text Out of Network Coverage Description Text Does Deductible Apply Boolean Additional Information Note Text Time Period Description Text -
Configure the data stream for the Coverage Benefit Item Limit object.
Field Data Type Coverage Benefit Item Limit ID Text - Primary Key Coverage Benefit Item Text Care Limit Type Text Name Text Network Type Text Term Type Text Limit Note Text Allowed Limit Value Text Applied Limit Value Text -
Configure the data stream for the Care Limit Type object.
Field Data Type Care Limit Type ID Text - Primary Key Limit Type Code Text Metric Type Text
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Configure the data stream for the Individual object.
