[SO/URSA-CORE] Other Outpatient Encounters

  • Published on Apr 10, 2026
  • 4 minute(s) read
Prev Next

Object Description

One record per outpatient encounter not captured by any other Ursa encounter type. These other outpatient encounters may only span a single calendar day, and capture all patient documents not already associated with another encounter with an effective date of that day.

Metadata

  • Table Name: ursa.so_ursa_core_enc_019
  • Layer: SYNTHETIC_OBJECT
  • Object Type: Single Stack
  • Temporal Class: Event
  • Case ID: Encounter ID
  • Event Date: Encounter Date
  • Primary Key: Encounter ID

Published Fields

  • Data Model Keys

    • Encounter ID -- The internal database identifier (used, e.g., for joins and primary keys) for the encounter. (See also [URSA-CORE] Encounter)
    • 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)
    • Encounter Primary Payor ID -- Data model key for the primary payor documented in the billing for an encounter.
    • Encounter Primary Plan ID -- Data model key for the primary plan documented in the billing for an encounter.
    • Facility Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the facility provider. (See also [URSA-CORE] Facility Provider)
    • 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)
    • Attending Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the attending provider. (See also [URSA-CORE] Attending Provider)
    • Provider Group Provider ID -- The internal database identifier (used, e.g., for joins and primary keys) for the provider group. (See also [URSA-CORE] Provider Group)

  • Date Fields

    • Encounter Date

  • Encounter Fields

    • Primary Service Document HCPCS Code
    • Primary Service Document CMS Revenue Center Code
    • Primary Service Document EMR Encounter Type Description
    • Is FQHC Encounter
    • Is RHC Encounter

  • Diagnosis Fields

    • Principal Diagnosis ICD-9-CM Code -- The ICD-9-CM diagnosis code documented as the principal diagnosis for a claim, bill, encounter, etc. (See also [URSA-CORE] Diagnosis ICD-9-CM Code)
    • Principal Diagnosis ICD-9-CM Description -- The natural language description of the Principal Diagnosis ICD-9-CM Code. (See also [URSA-CORE] Principal Diagnosis ICD-9-CM Code)
    • Principal Diagnosis ICD-10-CM Code -- The ICD-10-CM diagnosis code documented as the principal diagnosis for a claim, bill, encounter, etc.
    • Principal Diagnosis ICD-10-CM Description -- The natural language description of the Principal Diagnosis ICD-10-CM Code. (See also [URSA-CORE] Principal Diagnosis ICD-10-CM Code)

  • 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 Admit Type Code -- The standard single-digit CMS inpatient admission type code found on Inpatient and Skilled Nursing Facility claims; ; 1 = Emergency, 2 = Urgent, 3 = Elective, 4 = Newborn, 5 = Trauma Center, 9 = Information Not Available.
    • CMS Admit Source Code -- The standard 1-character CMS Admit Source code; e.g., 1 = Physician Referral, 2 = Clinic Referral, etc.
    • CMS Patient Discharge Status Code -- The standard 2-digit CMS Patient Discharge Status code; 01 = Discharged to Home or Self Care, etc. Patient Discharge Status codes should include leading zeros.

  • Financial Fields

    • Primary Plan Allowed Amount -- The maximum amount that the payor agrees to pay the provider for a service or product, typically governed by a contract. The Allowed Amount for a claim or billing record is calculated by adding the Contractual Adjustment Amount (which is typically negative) to the Charge Amount. Adding the total Non-Contractual Adjustment Amount to the Allowed Amount yields the Total Due Amount. On billing records, which may identify up to three plans responsible for payment, the Primary Plan Allowed Amount, Secondary Plan Allowed Amount, and Tertiary Plan Allowed Amount fields identify the amounts paid by the primary, secondary, and tertiary plans listed on the bill, respectively. (See also [URSA-CORE] Charge Amount, [URSA-CORE] Contractual Adjustment Amount, [URSA-CORE] Non-Contractual Adjustment Amount, [URSA-CORE] Total Due Amount)
    • Primary Plan Paid Amount -- The amount actually paid by the health plan to the provider for a service or product. Subtracting the plan paid amount from the total due amount typically yields the patient responsibility amount. On billing records, which may identify up to three plans responsible for payment, the Primary Plan Paid Amount, Secondary Plan Paid Amount, and Tertiary Plan Paid Amount fields identify the amounts paid by the primary, secondary, and tertiary plans listed on the bill, respectively; the total paid by any and all plans on a bill is identified by the Any Plan Paid Amount field.
    • Total Plan Paid Amount from All Plans
    • Patient Paid Amount -- The amount paid by the patient to the provider for health care services or products.

Terms

  • Clinician Office Visit: An encounter in which the patient received in-person care from a clinical provider, including non-physicians, in an office or clinic setting; operationally defined by the presence of one or more of the following: (1) a qualifying HCPCS code on a professional claim or bill service line item, or on an EMR encounter service line item; (2) a qualifying HCPCS or revenue center code on an institutional claim or bill service line item associated with a claim or bill with a qualifying type of bill code; or (3) an EMR encounter record flagged as a clinician office visit (i.e., Is Encounter Type Clinician Office Visit = 1). Qualifying records are considered to be part of the same encounter if they share the same patient, service date, and service provider, billing provider, or provider group.

Foreign Keys

  • pat_id → ursa.no_ursa_core_pat_001.pat_id
  • enc_primary_payor_id → ursa.no_ursa_core_struct_004.payor_id
  • enc_primary_plan_id → ursa.no_ursa_core_struct_005.plan_id
  • facility_prov_id → ursa.no_ursa_core_prov_001.prov_id
  • service_prov_id → ursa.no_ursa_core_prov_001.prov_id
  • attending_prov_id → ursa.no_ursa_core_prov_001.prov_id
  • prov_group_prov_id → ursa.no_ursa_core_prov_001.prov_id