Standard Reports: Roster

Primary Data Source: CareHub

Please note that when we share a roster report to your TPA, we will include a full history with the most up to date participant information in the file. If a request is made for only providing changes, this would be a non-standard integration requiring consultation with your implementation team.

Field	Date Type	Description	Source
Organization	Text	The high level organization name.	CareHub
Contract Number	Text	The H number of the organization.	CareHub
Center	Text	The name of the specific site to which the participant is attributed.	CareHub
Team	Text	If applicable, the team to which the participant is attributed.	CareHub
PCP Name	Text	The name of the primary care provider to which the participant is attributed.	CareHub
Elation Patient Id	Text	The ID of the patient in Elation.	CareHub
Member ID	Text	The PACE organization’s member id for the participant.	CareHub
First Name	Text		CareHub
Middle Name	Text		CareHub
Last Name	Text		CareHub
DOB	Date	In the format of MM/DD/YYYY	CareHub
Gender	Text		CareHub
Enrollment Status	Text	Either Enrolled or Disenrolled	CareHub
Enrollment Date	Date	In the format of MM/DD/YYYY	CareHub
Disenrollment Date	Date	In the format of MM/DD/YYYY	CareHub
MBI	Text	Medicare Beneficiary Id	CareHub
HICN	Text	If available the Health Insurance Claims Number (HICN) for the participant	N/A not available in CareHub
Medicaid ID	Text	Medicaid ID if applicable.	CareHub
Insurance Status	Text	One of the following: Medicare Medicaid Dual Eligible Private Pay	CareHub
Address Line 1		Most recent participant address	CareHub
Address Line 2		Most recent participant address	CareHub
City		Most recent participant address	CareHub
State		Most recent participant address	CareHub
Zip Code		Most recent participant address	CareHub
Primary Phone		Primary phone number of the participant	CareHub
VA Status	Text	Value as recorded in CH Participant	CareHub
ESRD Status	Text	Value as recorded in CH Participant	CareHub
Code Status	Text	Value as recorded	CareHub
Power of Attorney	Text	Value as recorded	CareHub
Health Power of Attorney	Text	Value as recorded	CareHub
DNR Orders	Text	Value as recorded	CareHub
Will Prepared	Text	Value as recorded	CareHub
POLST	Text	Value as recorded	CareHub