Triple-S Management · JSON Structure

Triple S Management Member Structure

JSON structure documentation for Triple-S health plan member and claims objects

Type: Properties: 0
Health InsuranceManaged CareMedicare AdvantagePuerto RicoBlue Cross Blue ShieldHealthcare

Triple S Management Member Structure is a JSON Structure definition published by Triple-S Management.

Meta-schema:

JSON Structure

triple-s-management-member-structure.json Raw ↑
{
  "title": "Triple-S Management Member Structure",
  "description": "JSON structure documentation for Triple-S health plan member and claims objects",
  "version": "1.0.0",
  "structures": [
    {
      "name": "Member",
      "description": "A Triple-S health plan member with coverage and eligibility details",
      "fields": [
        { "name": "memberId", "type": "string", "required": true, "description": "Unique member identifier" },
        { "name": "name", "type": "object", "required": true, "description": "Member name (first, last, middle)" },
        { "name": "dateOfBirth", "type": "date", "required": false, "description": "Member date of birth" },
        { "name": "planType", "type": "string", "required": true, "description": "Type of health plan" },
        { "name": "planId", "type": "string", "required": false, "description": "Health plan identifier" },
        { "name": "groupNumber", "type": "string", "required": false, "description": "Employer group number" },
        { "name": "effectiveDate", "type": "date", "required": false, "description": "Coverage effective date" },
        { "name": "terminationDate", "type": "date", "required": false, "description": "Coverage termination date" },
        { "name": "eligibilityStatus", "type": "string", "required": false, "description": "Active, Inactive, Terminated, Pending" },
        { "name": "primaryCareProvider", "type": "object", "required": false, "description": "Assigned PCP information" },
        { "name": "network", "type": "string", "required": false, "description": "Provider network" }
      ]
    }
  ]
}