[NO/URSA-QUALITY] Patient-Plan Timelines of Plan Membership Extension for URSA-QUALITY Concepts

Object Description

One record per patient-plan timeline period in which the patient had an active membership in the plan; overlapping periods are reconciled to eliminate overlapping periods, with precedence given to the period with the more recent start date.

Metadata

• Table Name: ursa.no_ursa_quality_fin_005
• Layer: NATURAL_OBJECT
• Object Type: Simple Timeline
• Temporal Class: Interval (Timeline)
• Case ID: Patient ID, Plan ID
• Interval Start Date: Period Start Date
• Interval End Date: Period End Date
• Primary Key: Patient ID, Plan ID, Period Start Date, Period End Date

Published Fields

• Data Model Keys

  • 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)
  • Plan ID -- The identifier for a particular health insurance plan product offered by a payor.
  • Source ID -- The identifier for the original source data system from which the current record originated.

• Date Fields

  • Period Start Date
  • Period End Date

• Insurance Fields

  • NCQA Payer Type Code
  • Is Commercial NCQA Payer Type Code
  • Is Medicare NCQA Payer Type Code
  • Is Medicaid NCQA Payer Type Code
  • Is SNP NCQA Payer Type Code
  • Is Exchange NCQA Payer Type Code
  • Is MMP NCQA Payer Type Code
  • Output Commercial NCQA Payer Type Code
  • Output Medicare NCQA Payer Type Code
  • Output Medicaid NCQA Payer Type Code
  • Output SNP NCQA Payer Type Code
  • Output Exchange NCQA Payer Type Code
  • Output MMP NCQA Payer Type Code
  • Is Commercial Output NCQA Payer Type Code
  • Is Medicare Output NCQA Payer Type Code
  • Is Medicaid Output NCQA Payer Type Code
  • Is SNP Output NCQA Payer Type Code
  • Is Exchange Output NCQA Payer Type Code
  • Is MMP Output NCQA Payer Type Code
  • Is NCQA Dental Benefit
  • Is NCQA Inpatient Mental Health Benefit
  • Is NCQA Intensive Outpatient Mental Health Benefit
  • Is NCQA Outpatient Mental Health Benefit
  • Is NCQA Inpatient Chemical Dependency Benefit
  • Is NCQA Intensive Outpatient Chemical Dependency Benefit
  • Is NCQA Outpatient Chemical Dependency Benefit
  • Is NCQA Institutional Long-Term Services and Support Benefit
  • Is NCQA Home and Community Long-Term Services and Support Benefit
  • Is NCQA Health Plan Employee

Foreign Keys

• plan_id → ursa.no_ursa_core_struct_005.plan_id
• payor_id → ursa.no_ursa_core_struct_004.payor_id
• subscriber_pat_id → ursa.no_ursa_core_pat_001.pat_id
• plan_attributee_prov_id → ursa.no_ursa_core_prov_001.prov_id
• plan_attributee_individual_prov_id → ursa.no_ursa_core_prov_001.prov_id
• plan_attributee_prov_group_prov_id → ursa.no_ursa_core_prov_001.prov_id
• pat_id → ursa.no_ursa_core_pat_001.pat_id

Dedicated Precursors

• [NO/URSA-QUALITY] Patient-Plan Timelines of Plan Membership Extension for URSA-QUALITY Concepts, Precursor 1 (All Source Records): One record per patient-plan timeline period during which the patient had an active membership in the health plan. Includes fields used in the URSA-QUALITY logic.