[NO/URSA-CORE] Institutional Bill Service Line Items

Object Description

One record per institutional bill service line item.

Metadata

• Table Name: ursa.no_ursa_core_fin_012
• Layer: NATURAL_OBJECT
• Object Type: Single Stack
• Temporal Class: Event
• Case ID: Bill Service Line Item ID
• Event Date: Service Start Date
• Primary Key: Bill Service Line Item ID

Published Fields

• Data Model Keys

  • Bill Service Line Item ID -- The identifier for a service line item on an institutional or professional bill.
  • Bill ID -- The identifier for a professional or institutional bill header record; Bill ID values are consistent over the lifetime of a bill, including when a bill is adjusted. On a claim record, this field refers to the bill sent to the plan that originated the claim record.
  • Service Line Number -- The integer-valued ordinal representing the position of a service line item in a claim, bill, encounter, or other master record. May not necessarily match the analogous value in the source data for the same record.
  • Patient ID -- The internal database identifier (used, e.g., for joins and primary keys) for the patient. This value is typically mastered, i.e., all records for the same patient, regardless of the source data system from which that record originated, should have the same Patient ID value. (Note that while the mastered Patient ID value might resemble a local identifier used in one of the upstream data sources, this does not indicate any special priority of that source system in determining the characteristics of the patient.) (See also [URSA-CORE] Patient)
  • Service Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the service provider. (See also [URSA-CORE] Service Provider)
  • EMR Encounter ID -- The internal database identifier (used, e.g., for joins and primary keys) for the EMR encounter. (See also [URSA-CORE] EMR Encounter)
  • EMR Encounter Service Line Item ID -- The identifier for the instance of a performed service during an EMR Encounter.
  • Document ID
  • Source ID -- The identifier for the original source data system from which the current record originated.

• Source Local Keys

  • Source Local Bill Service Line Item ID -- The identifier for the bill service line item in the original source data system. On a claim record, this field refers to the bill sent to the plan that originated the claim record.
  • Source Local Bill ID -- The identifier for the bill in the original source data system. On a claim record, this field refers to the bill sent to the plan that originated the claim record.
  • Source Local Service Line Number -- The integer-valued ordinal for a service line item in the original source data system.
  • Source Local Patient ID -- The internal database identifier for the patient in the source data system this record originated from. (See also [URSA-CORE] Patient)

• Operations Support Fields

  • Bill Service Line Item Operational ID

• Date Fields

  • Service Start Date -- The first calendar date a service was delivered.
  • Service End Date -- The last calendar date a service was delivered.
  • Bill Covered Start Date
  • Bill Covered End Date
  • Service Line Item Posted Date

• Provider Fields

  • Service Provider NPI -- The 10-digit National Provider Identifier for the service provider. (See also [URSA-CORE] Service Provider)
  • Service Provider Description -- The natural language description of the service provider; typically, the name of the provider. (See also [URSA-CORE] Service Provider)

• Clinical Services Fields

  • HCPCS Code -- The Healthcare Common Procedure Coding System (HCPCS) code associated with a service. Includes both HCPCS Level I codes (commonly called CPT codes) and Level II codes (which includes products, supplies, and services not included in CPT). Level II codes consist of a letter followed by four numeric digits. Current Dental Terminology codes are included in the Level II codes as HCDT. (See also [URSA-CORE] HCPCS Description)
  • HCPCS Description -- The natural language description of a HCPCS code. (See also [URSA-CORE] HCPCS Code)
  • HCPCS Modifier 1 Code -- The 2-character code modifying a HCPCS code.
  • HCPCS Modifier 1 Description -- The natural language description of a HCPCS code modifier. (See also [URSA-CORE] HCPCS Modifier Code)
  • HCPCS Modifier 2 Code
  • HCPCS Modifier 2 Description
  • HCPCS Modifier 3 Code
  • HCPCS Modifier 3 Description
  • HCPCS Modifier 4 Code
  • HCPCS Modifier 4 Description
  • HCPCS Modifier 5 Code
  • HCPCS Modifier 5 Description
  • CMS Revenue Center Code -- The standard CMS 4-digit Revenue Center code; e.g., 0001 = Total charge, etc. CMS Revenue Center codes should include leading zeros.
  • CMS Revenue Center Description -- The natural language description of a CMS Revenue Center code (See also [URSA-CORE] CMS Revenue Center Code)
  • HIPPS Code -- The standard CMS 5-digit Health Insurance Prospective Payment System (HIPPS) code; e.g., AAA00 = Default Code.
  • HIPPS Description -- The natural language description of a HIPPS code. (See also [URSA-CORE] HIPPS Code)
  • Service Unit Count -- The number of units of a service delivered to the patient; includes non-integer values, if appropriate.

• Billing and Claims Fields

  • CMS Place of Service Code -- The standard CMS 2-digit Place of Service code; e.g., 01 = Pharmacy, 02 = Telehealth, etc.
  • CMS Place of Service Description -- The natural language description of a standard CMS Place of Service code (See also [URSA-CORE] CMS Place of Service Code)
  • Is Bill Service Line Item Processed Status Open
  • Is Bill Service Line Item Processed Status Closed
  • Is Bill Service Line Item Primary Plan Processed Status Denied
  • Is Bill Service Line Item Secondary Plan Processed Status Denied
  • Is Bill Service Line Item Tertiary Plan Processed Status Denied

• Financial Fields

  • Bill Service Line Item Charge Amount -- The Charge Amount for the bill service line item. (See also [URSA-CORE] Charge Amount)
  • Bill Service Line Item Contractual Adjustment Amount -- The Contractual Adjustment Amount for the bill service line item. (See also [URSA-CORE] Contractual Adjustment Amount)
  • Bill Service Line Item Primary Plan Allowed Amount -- The Primary Plan Allowed Amount for the bill service line item. (See also [URSA-CORE] Allowed Amount)
  • Bill Service Line Item Secondary Plan Allowed Amount -- The Secondary Plan Allowed Amount for the bill service line item. (See also [URSA-CORE] Allowed Amount)
  • Bill Service Line Item Tertiary Plan Allowed Amount -- The Tertiary Plan Allowed Amount for the bill service line item. (See also [URSA-CORE] Allowed Amount)
  • Bill Service Line Item Non-Contractual Adjustment Amount -- The Non-Contractual Adjustment Amount for the bill service line item. (See also [URSA-CORE] Non-Contractual Adjustment Amount)
  • Bill Service Line Item Total Due Amount -- The Total Due Amount for the bill service line item. (See also [URSA-CORE] Total Due Amount)
  • Bill Service Line Item Primary Plan Paid Amount -- The Primary Plan Paid Amount for the bill service line item. (See also [URSA-CORE] Plan Paid Amount)
  • Bill Service Line Item Secondary Plan Paid Amount -- The Secondary Plan Paid Amount for the bill service line item. (See also [URSA-CORE] Plan Paid Amount)
  • Bill Service Line Item Tertiary Plan Paid Amount -- The Tertiary Plan Paid Amount for the bill service line item. (See also [URSA-CORE] Plan Paid Amount)
  • Bill Service Line Item Any Plan Paid Amount -- The Any Plan Paid Amount for the bill service line item. (See also [URSA-CORE] Plan Paid Amount)
  • Bill Service Line Item Patient Responsibility Amount -- The Patient Responsibility Amount for the bill service line item. (See also [URSA-CORE] Patient Responsibility Amount)
  • Bill Service Line Item Patient Paid Amount -- The Patient Paid Amount for the bill service line item. (See also [URSA-CORE] Patient Paid Amount)
  • Bill Service Line Item Bad Debt Write-Off Amount -- The Bad Debt Write-Off Amount for the bill service line item. (See also [URSA-CORE] Bad Debt Write-Off Amount)

• Metadata Fields

  • Is Service Line Item Financial Data Coverage -- Indicates whether financial information associated with a bill or claim is available and generally accurate at the service line item level; a value of 0 indicates that line-level financials are not available or not reliably accurate, and that header-level financial information should be used despite its coarser grain.
  • Other EMR Comments -- Any other annotations or comments associated with the current record entered into the EMR.
  • Record Last Updated Datetime -- The date and time the current record was last updated in the original data source.
  • Source Data Effective Datetime -- The "as of" date and time of the original source data system at the moment the current record was extracted. For example, if a snapshot of the data in a production system is taken at 12:05 AM on the first of each month and used to generate a package of flat files that are eventually loaded into the Ursa Studio client database later that month, the Source Data Effective Datetime of all records in that month's package will be 12:05 AM on the first. Not to be confused with Record Last Updated Datetime. (See also [URSA-CORE] Record Last Updated Datetime)

Foreign Keys

• bill_id → ursa.no_ursa_core_fin_011.bill_id
• pat_id → ursa.no_ursa_core_pat_001.pat_id
• service_prov_id → ursa.no_ursa_core_prov_001.prov_id
• emr_enc_id → ursa.no_ursa_core_enc_001.emr_enc_id
• emr_enc_service_line_item_id → ursa.no_ursa_core_enc_002.emr_enc_service_line_item_id

Dedicated Precursors

• [NO/URSA-CORE] Institutional Bill Service Line Items, Precursor 1 (All Source Records): One record per institutional bill service line item