[SO/URSA-CKD] Clinician Office Visits with Nephrology Provider

Object Description

One record per clinician office visit with a nephrologist or with a clinician at a nephrology provider group.

Metadata

• Table Name: ursa.so_ursa_ckd_enc_001
• 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

• Provider Fields

  • Service Provider Description
  • Attending Provider Description
  • Provider Group Description

• Diagnosis Fields

  • Principal Discharge Diagnosis ICD-10-CM Code
  • Principal Discharge Diagnosis ICD-10-CM Description

• 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.

• Metadata Fields

  • Is Qualifying Service Provider
  • Is Qualifying Attending Provider
  • Is Qualifying Provider Group

Terms

• Clinician Office Visit with Nephrology Provider: A clinician office visit with a nephrologist or other clinician providing nephrology-related care. Identified by the presence of a nephrologist attending and/or service provider, or the presence of a nephrology group provider as the billing provider or provider group on the encounter.

Foreign Keys

• pat_id → ursa.no_ursa_core_pat_001.pat_id
• enc_id → ursa.so_ursa_core_enc_002.enc_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