[SO/URSA-CORE] Clinician Office Visits

Object Description

One record per Clinician Office Visit encounter; this object executes the logic to generate the final encounter-level properties based on the full set of documents related to the encounter collected in the aggregator object.

Metadata

• Table Name: ursa.so_ursa_core_enc_002
• 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
  • Encounter Primary Plan ID
  • Facility Provider ID
  • Service Provider ID
  • Attending Provider ID
  • Provider Group Provider ID

• Date Fields

  • Encounter Date

• Encounter Fields

  • Is Urgent Care Visit
  • Qualifying Document HCPCS Code
  • Qualifying Document CMS Revenue Center Code
  • Qualifying Document EMR Encounter Type Description

• Diagnosis Fields

  • Principal Discharge Diagnosis ICD-9-CM Code
  • Principal Discharge Diagnosis ICD-9-CM Description
  • Principal Discharge Diagnosis ICD-10-CM Code
  • Principal Discharge Diagnosis ICD-10-CM Description

• Billing and Claims Fields

  • CMS Place of Service Code
  • CMS Admit Type Code
  • CMS Admit Source Code
  • CMS Patient Discharge Status Code

• Financial Fields

  • Primary Plan Allowed Amount
  • Primary Plan Paid Amount
  • Total Plan Paid Amount from All Plans
  • Patient Paid Amount

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