Billing Analytics Data Dictionary

Facts


In Microsoft Excel, ‘Facts’ are the actual numbers that you are able to analyze/report on.  This type of data is quantitative (numbers).

  • Fact Claim Charges: This data is derived from the charges (aka Procedures) on a claim.   
    • Charge Amount: The included charge dollar amount(s).
    • Charge Default RVURVUs as set in the Procedure for the currently included charges; will be totaled across all charges unless/until broken out by Procedure Code.
    • Charge Total RVUCharge units x Default RVUs (as set in the Procedure) for the currently included charges.
    • Charge Unit AmountTotal Charge Units x Charge Amount for the currently included charges.
    • Charge Units: The total charge units across all included claims.
    • Claim Count: The total claims making up the included charges.
    • Procedure Count: The number of unique procedures used across all included claims.
  • Fact Claim Payments: This data is derived from payments that are posted against procedures.   Keep in mind, both Payments and Adjustments are categorized as ‘Payments’.  So, it is often helpful to use a dimension (described below) to separate out Payments and Adjustments. 
    • Claim Count with Payments: The total included claims which have payments recorded.
    • Payment Amount: The included payment dollar amount(s).
    • Payments Count: The count of all included payments.



Dimensions


In Microsoft Excel, ‘Dimensions’ are how you might analyze or break down a number.  This type of data is qualitative (categories).

  • Claim Level: The current billing level (primary, secondary, tertiary, etc.) of the included claims.
    • Dim Level Type: The different billing levels, categorized by an iSalus internal unique identifier.
    • Level Type Code: The different billing levels, categorized by code.
      • 1 = Primary, 2 = Secondary, 3 = Tertiary, C = Completed, S = Statement, U = Unassigned
    • Level Type Description: The different billing levels by description.
    • Update Date: The last date the description of the Claim Level was modified within the database.
  • Claim Owner: The current user assigned as Owner on the included claim(s).
    • Dim User: Users who are assigned as owner(s) on the included claim(s), categorized by an iSalus internal unique identifier.
    • Update Date: The last date the user information tied to the owner was modified within the database.
    • User Code: The user ID of the owner(s) assigned to the included claim(s).
    • User Name: The full user name of the owner(s) assigned to the included claim(s).
  • Claim Primary Carrier: The current primary insurance carrier on the included claim(s).
    • Carrier Claim Filing Type: The Source of Pay (as chosen in Payer Setup) for the primary carrier on the included claim(s).
    • Carrier EDI: The clearinghouse (as chosen in Payer Setup) for the primary carrier on the included claim(s).
    • Carrier Financial Class: The Financial Class assigned to each payer (within Payer Setup) for the primary carrier on the included claim(s). 
    • Carrier Name: The descriptive payer name (as entered in Payer Setup) for the primary carrier on the included claim(s).
    • Carrier Payer ID: The claim submission payer ID (as entered in Payer Setup) for the primary carrier on the included claim(s).
    • Dim Primary Carrier: The primary carrier on the included claim(s), categorized by an iSalus internal unique identifier.
    • Update Date: The last date the description of the Primary Carrier was modified within the database.
  • Claim Primary Diagnosis: The current diagnosis code in the first (primary) diagnosis field on the included claim(s).
    • Diagnosis Code: The ICD alphanumeric code on the included claim(s).
    • Diagnosis Code Description: Both the ICD alphanumeric code and the text description on the included claim(s).
    • Diagnosis Description: The text description for the primary ICD code on the included claim(s).
    • Dim Primary Diagnosis: The primary diagnosis on the included claim(s), categorized by an iSalus internal unique identifier.
    • Update Date: The last date the description of the ICD alphanumeric was modified within the database.
  • Claim Status: The current Claim Status on the included claim(s).
    • Claim Status Description: The text description for the current Claim Status on the included claim(s).
    • Dim Claim Status: The current Claim Status on the included claim(s), categorized by an iSalus internal unique identifier.
    • Update Date: The last date the description of the Claim Status was modified within the database.
  • Claim Submission Type: The current Submission (Billing) Type (Electronic vs. Paper) on the included claim(s).
    • Billing Type Code: The current Submission (Billing Type) on the included claim(s), by code.
      • E = Electronic, P = Paper
    • Billing Type Description: The text description of the current Submission (Billing Type) on the included claim(s). 
    • Dim Billing Type: The current Submission (Billing) Type on the included claim(s), categorized by an iSalus internal unique identifier.
    • Update DateThe last date the description of the Claim Submission (Billing) Type was modified within the database.
  • Claim Substatus: The current Claim Substatus on the included claim(s).
    • Claim Sub Status Description: The text description for the current Claim Substatus on the included claim(s).
    • Dim Claim Substatus: The current Claim Substatus on the included claim(s), categorized by an iSalus internal unique identifier.
    • Update DateThe last date the description of the Claim Substatus was modified within the database.
  • Claim Type: The current Claim Type (Medical, Dental, EPSDT, DME, etc.) on the included claim(s). NOTE: Medical is the default Claim Type on all claims.
    • Claim Type Code: The current Claim Type on the included claim(s), by code.
      • F = Medical
    • Claim Type Description: The text description of the current Claim Type on the included claim(s). 
    • Dim Claim Type: The current Claim Type on the included claim(s), categorized by an iSalus internal unique identifier.
    • Update DateThe last date the description of the Claim Type was modified within the database.
  • Client: The current Client Database information on the included claim(s).
    • Client Alias: The client database assigned alias, associated with the included claim(s), which may be used to log into the database in the Company field on the login page.
    • Client Key: The client database auto assigned (when a new database is generated) key associated with the included claim(s).
    • Client Name: The client database auto assigned Company Name, associated with the included claim(s), which may be used to log into the database in the Company field on the login page.
    • Dim Client: The iSalus internal unique identifier for the client database associated with the included claim(s).
    • Update Date: The last date the assigned Company Name was modified within the database.
  • Date Claim Charge Analytic: The claim charge data date(s) as of the last time the data analytics was updated. iSalus does not recommend using this date.
    • Date Claim Charge Analytic.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim charge(s) starting by Year; example:
      • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
    • Date Claim Charge Analytic.Date Value: Selecting this value will break out the included claim charge(s) by calendar date, regardless of year.
    • Date Claim Charge Analytic.DateID: The iSalus unique identifier for the Claim Charge Analytic calendar date.
    • Date Claim Charge Analytic.Quarter Value: Selecting this value will break out the included claim charge(s) by Quarter, regardless of year.
    • Date Claim Charge Analytic.Year Month: Selecting this value will break out the included claim charge(s) by calendar month, regardless of year.
    • Date Claim Charge Analytic.Year Value: Selecting this value will break out the included claim charge(s) by year, with no additional breakdown.
  • Date Claim Charge Post: The claim charge data date(s) based on when the charges were posted/entered. This field can not be changed by users.
    • Date Claim Charge Post.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim charge(s) starting by Year; example:
      • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
    • Date Claim Charge Post.Date Value: Selecting this value will break out the included claim charge(s) by calendar date, regardless of year.
    • Date Claim Charge Post.DateID: The iSalus unique identifier for the Claim Charge Post calendar date.
    • Date Claim Charge Post.Quarter Value: Selecting this value will break out the included claim charge(s) by Quarter, regardless of year.
    • Date Claim Charge Post.Year MonthSelecting this value will break out the included claim charge(s) by calendar month, regardless of year.
    • Date Claim Charge Post.Year Value: Selecting this value will break out the included claim charge(s) by year, with no additional breakdown.
  • Date Claim Charge Service: The claim charge data date(s) as of the Charge Date of Service.   This field can be changed by users.
    • Date Claim Charge Service.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim charge(s) starting by Year; example:
      • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
    • Date Claim Charge Service.Date Value: Selecting this value will break out the included claim charge(s) by calendar date, regardless of year.
    • Date Claim Charge Service.DateID: The iSalus unique identifier for the Claim Charge Service calendar date.
    • Date Claim Charge Service.Quarter Value: Selecting this value will break out the included claim charge(s) by Quarter, regardless of year.
    • Date Claim Charge Service.Year Month: Selecting this value will break out the included claim charge(s) by calendar month, regardless of year.
    • Date Claim Charge Service.Year Value: Selecting this value will break out the included claim charge(s) by year, with no additional breakdown.
  • Date Claim Payment Analytic: The claim Payment data date(s) as of the last time the data analytics was updated. iSalus does not recommend using this date.
    • Date Claim Payment Analytic.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim payment(s) starting by Year; example:
      • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
    • Date Claim Payment Analytic.Date Value: Selecting this value will break out the included claim payment(s) by calendar date, regardless of year.
    • Date Claim Payment Analytic.DateIDThe iSalus unique identifier for the Claim Payment Analytic calendar date.
    • Date Claim Payment Analytic.Quarter Value: Selecting this value will break out the included claim payment(s) by Quarter, regardless of year.
    • Date Claim Payment Analytic.Year Month: Selecting this value will break out the included claim payment(s) by calendar month, regardless of year.
    • Date Claim Payment Analytic.Year Value: Selecting this value will break out the included claim payment(s) by year, with no additional breakdown.
  • Date Claim Payment Deposit: The claim Payment data date(s) based on Payment Deposit Date.   This field can be changed by users.
    • Date Claim Payment Deposit.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim payment(s) starting by Year; example:
      • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
    • Date Claim Payment Deposit.Date Value: Selecting this value will break out the included claim payment(s) by calendar date, regardless of year.
    • Date Claim Payment Deposit.DateIDThe iSalus unique identifier for the Claim Payment Deposit calendar date
    • Date Claim Payment Deposit.Quarter Value: Selecting this value will break out the included claim payment(s) by Quarter, regardless of year.
    • Date Claim Payment Deposit.Year Month: Selecting this value will break out the included claim payment(s) by calendar month, regardless of year.
    • Date Claim Payment Deposit.Year Value: Selecting this value will break out the included claim payment(s) by year, with no additional breakdown.
  • Date Claim Payment Post: The claim Payment data date(s) based on Payment Post Date. This field can not be changed by users.
    • Date Claim Payment Post.Year Value – Quarter Value – Year Month – Date Value: Selecting this value will break out the included claim payment(s) starting by Year; example:
      • 2018 -> Q1 -> January, February, March -> 2018-01-01, 2018-01-02, 2018-01-03, etc.
    • Date Claim Payment Post.Date Value: Selecting this value will break out the included claim payment(s) by calendar date, regardless of year.
    • Date Claim Payment Post.DateIDThe iSalus unique identifier for the Claim Payment Post calendar date
    • Date Claim Payment Post.Quarter Value: Selecting this value will break out the included claim payment(s) by Quarter, regardless of year.
    • Date Claim Payment Post.Year MonthSelecting this value will break out the included claim payment(s) by calendar month, regardless of year.
    • Date Claim Payment Post.Year Value: Selecting this value will break out the included claim payment(s) by year, with no additional breakdown.
  • Patient: Patient demographics information which applies to the included claim(s)
    • Patient City – Patient Zip Code: This will provide the patient's city of residence on the included claim(s), and will further break down to the patient's zip code, then patient chart number.
    • Patient City
    • Patient Address 1
    • Patient Address 2
    • Patient Birth Date
    • Patient Chart: Patient Chart Number, but hovering over chart number will tooltip additional patient demographic information 
    • Patient Employment Status
    • Patient External ID:
    • Patient First Name
    • Patient Full Name (First Name Last Name) 
    • Patient Gender
    • Patient is Active: Active Checkbox in Patient Setup is checked
    • Patient is Living: RHC Date field is blank in Patient Setup
    • Patient is Reportable: Reportable Checkbox in Patient Setup is checked
    • Patient Label: Patient Demographics which could be used to print an address label.
    • Patient Last Name
    • Patient Marital Status
    • Patient Reverse Name: Last name, First name
    • Patient RHC Date: Patient Date of Death – Respirations Have Ceased
    • Patient State
    • Patient Suffix Name
    • Patient Zip Code
    • Update Date: The last date any Patient Setup field was modified within the database.
  • Payment or Adjustment: Used only with Fact Claim Payment data, this breaks out the amounts of payments vs. adjustments for the included payment(s).
    • Dim Payment Type: The Payment Type on the included payment(s), categorized by an iSalus internal unique identifier.
    • Payment Type Code: The Payment Type on the included payment(s), by code.
      • Adj = Adjustments, Pay = Payments
    • Payment Type Description: The Payment Type on the included payment(s), by text.
    • Update DateThe last date the description of the Payment Type was modified within the database.
  • Payment Paid By: Used only with Fact Claim Payment data, this breaks out who are the payers on the included payment(s).
    • Dim Payment Paid By: The category of payer on the included payment(s), categorized by an iSalus internal unique identifier.
    • Payment Paid By Code: The category of payer on the included payment(s), by code.
      • * = Unknown, PAT = Patient, PYR = Payer, RSP = Responsible Party
    • Payment Paid By Description: The category of payer on the included payment(s), by text.
    • Update DateThe last date the Payment Paid By was modified within the database.
  • Posting Method: Used only with Fact Claim Payment data, this breaks out the payment method(s) used to make the included payment(s), such as cash, check, credit card, etc.
    • Dim Posting Method: The posting method(s) on the included payment(s), categorized by an iSalus internal unique identifier.
    • Posting Method Description: The posting method(s) on the included payment(s), by text.
    • Update DateThe last date the Posting (Payment) Method was modified within the database.
  • Posting Type: Used only with Fact Claim Payment data, this breaks out the payment or adjustment type(s) for the included payments, such as Insurance Check, Co-Pay, Courtesy Write-Off, etc.
    • Dim Posting Type: The posting type(s) on the included payments/adjustments, categorized by an iSalus internal unique identifier.
    • Posting Type Description: The posting method(s) on the included payment(s), by text.
    • Update Date: The last date the Posting (Payment) Type was modified within the database.
  • Procedure: The current procedure(s), either CPT or HCPCS, on the included claim(s).
    • Dim Procedure: The procedure(s) on the included claim(s), categorized by an iSalus internal unique identifier.
    • Procedure Code: The procedure code(s) on the included claim(s).
    • Procedure Code Description: Both the procedure alphanumeric code(s) and the text description for the included claim(s).
    • Procedure Description: The text description for any procedure code(s) on the included claim(s).
    • Procedure Group: The Code Class assigned to each CPT/HCPCS code(s) on the included claim(s).
    • Procedure Modifier: Modifiers used with procedures on the included claim(s).
    • Procedure POS: The Place of Service assigned to each CPT/HCPCS code(s) at the procedure code level on the included claim(s), by text description.
    • Update Date: The last date the Procedure Code was modified within the database.
  • Provider Alternate: The Alternate Provider (if any) currently on the included claim(s).
    • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
      • Provider Alternate.Dim Provider: The Alternate Provider on the included claim(s), categorized by an iSalus internal unique identifier.
      • Provider Alternate.Provider City
      • Provider Alternate.Provider DEA (alphanumeric value)
      • Provider Alternate.Provider First Name
      • Provider Alternate.Provider Full Name (First Name Last Name)
      • Provider Alternate.Provider Last Name
      • Provider Alternate.Provider Middle Name
      • Provider Alternate.Provider NPI (numeric value)
      • Provider Alternate.Provider NPI Name
      • Provider Alternate.Provider Reverse Name (Last Name, First Name)
      • Provider Alternate.Provider State
      • Provider Alternate.Provider Suffix Name
      • Provider Alternate.Provider Zip Code
      • Provider Alternate.Update Date: The last date the Provider was modified within the database.
  • Provider Attending: The Attending Provider (if any) currently on the included claim(s).
    • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
      • Provider Attending.Dim Provider: The Attending Provider on the included claim(s), categorized by an iSalus internal unique identifier.
      • Provider Attending.Provider City
      • Provider Attending.Provider DEA (alphanumeric value)
      • Provider Attending.Provider First Name
      • Provider Attending.Provider Full Name (First Name Last Name)
      • Provider Attending.Provider Last Name
      • Provider Attending.Provider Middle Name
      • Provider Attending.Provider NPI (numeric value)
      • Provider Attending.Provider NPI Name
      • Provider Attending.Provider Reverse Name (Last Name, First Name)
      • Provider Attending.Provider State
      • Provider Attending.Provider Suffix Name
      • Provider Attending.Provider Zip Code
      • Provider Attending.Update Date: The last date the Provider was modified within the database
  • Provider Ordering: The Ordering Provider (if any) currently on the included claim(s).
    • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
      • Provider Ordering.Dim Provider: The Ordering Provider on the included claim(s), categorized by an iSalus internal unique identifier.
      • Provider Ordering.Provider City
      • Provider Ordering.Provider DEA (alphanumeric value)
      • Provider Ordering.Provider First Name
      • Provider Ordering.Provider Full Name (First Name Last Name)
      • Provider Ordering.Provider Last Name
      • Provider Ordering.Provider Middle Name
      • Provider Ordering.Provider NPI (numeric value)
      • Provider Ordering.Provider NPI Name
      • Provider Ordering.Provider Reverse Name (Last Name, First Name)
      • Provider Ordering.Provider State
      • Provider Ordering.Provider Suffix Name
      • Provider Ordering.Provider Zip Code
      • Provider Ordering.Update Date: The last date the Provider was modified within the database.
  • Provider Purchasing: The Purchasing Provider (if any) currently on the included claim(s).
    • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
      • Provider Purchasing.Dim Provider: The Purchasing Provider on the included claim(s), categorized by an iSalus internal unique identifier.
      • Provider Purchasing.Provider City
      • Provider Purchasing.Provider DEA (alphanumeric value)
      • Provider Purchasing.Provider First Name
      • Provider Purchasing.Provider Full Name (First Name Last Name)
      • Provider Purchasing.Provider Last Name
      • Provider Purchasing.Provider Middle Name
      • Provider Purchasing.Provider NPI (numeric value)
      • Provider Purchasing.Provider NPI Name
      • Provider Purchasing.Provider Reverse Name (Last Name, First Name)
      • Provider Purchasing.Provider State
      • Provider Purchasing.Provider Suffix Name
      • Provider Purchasing.Provider Zip Code
      • Provider Purchasing.Update Date: The last date the Provider was modified within the database.
  • Provider Referring: The Referring Provider (if any) currently on the included claim(s).
    • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
      • Provider Referring.Dim Provider: The Referring Provider on the included claim(s), categorized by an iSalus internal unique identifier.
      • Provider Referring.Provider City
      • Provider Referring.Provider DEA (alphanumeric value)
      • Provider Referring.Provider First Name
      • Provider Referring.Provider Full Name (First Name Last Name)
      • Provider Referring.Provider Last Name
      • Provider Referring.Provider Middle Name
      • Provider Referring.Provider NPI (numeric value)
      • Provider Referring.Provider NPI Name
      • Provider Referring.Provider Reverse Name (Last Name, First Name)
      • Provider Referring.Provider State
      • Provider Referring.Provider Suffix Name
      • Provider Referring.Provider Zip Code
      • Provider Referring.Update Date: The last date the Provider was modified within the database.
  • Provider Rendering: The Rendering Provider currently on the included claim(s).
    • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
      • Provider Rendering.Dim Provider: The Rendering Provider on the included claim(s), categorized by an iSalus internal unique identifier.
      • Provider Rendering.Provider City
      • Provider Rendering.Provider DEA (alphanumeric value)
      • Provider Rendering.Provider First Name
      • Provider Rendering.Provider Full Name (First Name Last Name)
      • Provider Rendering.Provider Last Name
      • Provider Rendering.Provider Middle Name
      • Provider Rendering.Provider NPI (numeric value)
      • Provider Rendering.Provider NPI Name
      • Provider Rendering.Provider Reverse Name (Last Name, First Name)
      • Provider Rendering.Provider State
      • Provider Rendering.Provider Suffix Name
      • Provider Rendering.Provider Zip Code
      • Provider Rendering.Update Date: The last date the Provider was modified within the database.
  • Provider Supervising: The Supervising Provider (if any) currently on the included claim(s).
    • Additional Provider Fields (some self-explanatory); all fields apply only to included claim(s):
      • Provider Supervising.Dim Provider: The Supervising Provider on the included claim(s), categorized by an iSalus internal unique identifier.
      • Provider Supervising.Provider City
      • Provider Supervising.Provider DEA (alphanumeric value)
      • Provider Supervising.Provider First Name
      • Provider Supervising.Provider Full Name (First Name Last Name)
      • Provider Supervising.Provider Last Name
      • Provider Supervising.Provider Middle Name
      • Provider Supervising.Provider NPI (numeric value)
      • Provider Supervising.Provider NPI Name
      • Provider Supervising.Provider Reverse Name (Last Name, First Name)
      • Provider Supervising.Provider State
      • Provider Supervising.Provider Suffix Name
      • Provider Supervising.Provider Zip Code
      • Provider Supervising.Update Date: The last date the Provider was modified within the database.
  • Service Location: The Service Location currently on the included claim(s). Most fields are self-explanatory.
    • Dim Service Location: The Service Location on the included claim(s), categorized by an iSalus internal unique identifier.
    • Service Location City
    • Service Location Name
    • Service Location State
    • Service Location Type: Facility, Lab, Other
    • Service Location Zip Code
    • Update Date: The last date the Service Location was modified within the database.