NDFP > Eligibility

Entity

Data Element

Definition

Format

Valid Values

Purpose and Use

Change

Eligibility

Attending Physician

Name of attending doctor and CPSO number

CHARACTER

Collected to identify the most responsible physician, verifying the patient’s eligibility for reimbursement. May be used periodically for statistical or analytical purposes.

Eligibility

Body Surface Area

Patient Body Surface Area (m2)

REAL

Any positive real number

Used to establish baseline patient information for dosing. Used for system planning and budgeting.

Eligibility

Height

Patient Height in cm

REAL

Any positive real number

Used to establish baseline patient information for dosing. Used for system planning and budgeting.

Eligibility

Weight

Patient Weight in kg

REAL

Any positive real number

Used to establish baseline patient information for dosing. Used for system planning and budgeting

Eligibility

Clinical Trial Flag

Identifies whether the treatment is given as part of a clinical trial

CHAR 1

Y, N, Y- Other                   

However, historical records prior to eClaims (2013) won't have this data element.

Collected to support clinical trials policy and to confirm patient eligibility for reimbursement.

Eligibility

Clinical Trial

The name of the clinical trial that the patient is on

 CHARACTER

Table in eClaims

Collected to support clinical trials policy and to determine patient eligibility.

Eligibility

Clinical Trial Arm

Identifies whether the patient is on the experimental or standard of care arm

CHARACTER 

Standard of care arm, experimental arm, blinded / unknown

Collected to support clinical trials policy and to determine patient eligibility.

Eligibility

Site

The facility that enrolled the patient

CHARACTER 

Table in eClaims

Collected to identify facility that enrolled the patient. Used for communication purposes to confirm eligibility for reimbursement.

May be used periodically for statistical or analytical purposes.

Eligibility

Prior Approval Flag

Flags that a prior approval was requested for this enrolment

CHAR 1

Y, N

Collected to identify if a prior approval was requested for this policy.

May be used periodically for statistical or analytical purposes.

Eligibility

Policy

Description of the eligible drug, indication and intent for which reimbursement is being requested

CHARACTER

Pick from list of policies/enrollment forms

Uniquely identifies the conditions for reimbursement of this drug in a specific setting (i.e., disease, line of therapy)