Financial
The Health Chain Financial Data Mart is a centralized repository designed to provide comprehensive financial insights. It encompasses a range of data, including claims, claim status, unit price, age and age group, coverage type, date of service, cost of care, location, and more.
| Table | Column | Datatype | Description |
|---|---|---|---|
| hc_explanationOfbenefit | eob_id | varchar | FHIR record UUID |
| hc_explanationOfbenefit | status | varchar | ExplanationOfBenefitsStatus active | cancelled | draft | entered-in-error |
| hc_explanationOfbenefit | outcome | varchar | Claim Processing Codes queued | complete | error | partial |
| hc_explanationOfbenefit | billable_period_start | datetime | Relevant start time for the claim |
| hc_explanationOfbenefit | billable_period_end | datetime | Relevant end time for the claim |
| hc_adjudication | adjudication_value | decimal | Monetary amount, An amount of economic utility in some recognized currency. |
| hc_codeableconcept | codeableconcept_code | varchar | Type of adjudication information. Filtered on the category of adjudication. |
| hc_explanation_of_benefit_item | unitprice_value | decimal | Fee, charge or cost per item |
| hc_explanation_of_benefit_item | quantity_value | decimal | Count of products or services |
| hc_explanation_of_benefit_item | net_value | decimal | Total item cost |
| hc_explanation_of_benefit_item | serviced_date | datetime | Date or dates of service or product delivery |
| hc_patient | patient_id | varchar | FHIR record UUID |
| hc_patient | gender | varchar | Administrative Gender male | female | other | unknown |
| hc_identifier | ethnicity | varchar | For fhir_id & Identifier System - http://hl7.org/fhir/v2/0189 (Ethnicity) |
| hc_identifier | race | varchar | For fhir_id & Identifier System - http://hl7.org/fhir/v2/0189 (Race) |
| N/A | age | decimal | Calculated on the birth_date |
| N/A | age_group | varchar | Calculated on the birth_date |
| hc_address | city | varchar | An address for the individual, Name of city, town, etc. |
| hc_address | state | varchar | An address for the individual, Sub-unit of country (abbreviations ok). |
| hc_coverage | coverage_id | varchar | FHIR record UUID |
| hc_coverage | period_start | datetime | Coverage start date |
| hc_coverage | period_end | datetime | Coverage end date |
| hc_coverage | coverage_status | varchar | active | cancelled | draft | entered-in-error |
| hc_codeableconcept | coverage_type | varchar | Coverage category such as medical or accident |
| hc_account | account_id | varchar | FHIR record UUID |
| hc_account | serviceperiod_start | datetime | Coverage start date |
| hc_account | serviceperiod_end | datetime | Coverage end date |
| hc_account | account_status | varchar | active | cancelled | draft | entered-in-error |
| hc_coverage_eligibility_response | purpose | varchar | auth-requirements | benefits | discovery | validation |
| hc_coverage_eligibility_response | status | varchar | active | cancelled | draft | entered-in-error |
| hc_coverage_eligibility_response | outcome | varchar | queued | complete | error | partial |
| hc_coverage_eligibility_response | disposition | varchar | Disposition Message |
Member Risk Profile
The Health Chain Member Risk Profile data mart is a specialized, centralized repository of data designed to drive risk management insights, including but not limited to; diagnoses codes, risk assessment, risk score assigned to the member, risk assessment date, practitioner, and more!
Member Summary
The Health Chain Member Summary Data mart is a specialized, centralized repository of data designed to drive member-level insights, including but not limited to; encounters, diagnoses, demographics, costs, allowed amounts vs. paid amounts, facilities and more!
PMPM Chart
The Health Chain PMPM Chart data mart is a specialized, centralized repository of data designed to drive member-level financial insights, including but not limited to; claims, allowed amounts vs. paid amounts, month over month costs, plan type, type of encounters, itemized costs, encounter volume, and more!
Quality Analytics
Data marts are specialized subsets of data warehouses designed to serve the needs of a specific group within an organization. They are built using SQL code that automatically runs on top of the Common Data Model to compute specific measures, groupings, risk models, and other analytical constructs. Data marts frequently employ value sets to define the concepts they use, ensuring consistent and accurate data interpretations across various analytical processes.
Each of these views is derived from the Health Chain Common Data Model, ensuring consistency and reliability in the data. The Health Chain Quality Analytics data mart is a specialized, centralized repository of data designed to drive individual measure-level insights at both the member and population level, including but not limited to; measure name, numerator, denominator, observation date and more!