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tuva-health / tuva

Main repo including core data model, data marts, reference data, terminology, and the clinical concept library
https://thetuvaproject.com/
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Consider adding claim record type #285

Open sarah-tuva opened 10 months ago

sarah-tuva commented 10 months ago

The claim_record_type field represents the three types of claim records; original, adjustment, and reversal. See KB article for reference.

We need to decide if we should add this to the data model and where. We may not want to bring this field into the downstream marts or even allow denied/reversed claims. If so, we would need to filter out in the core mart and include this field in the input layer.

There are a few community use cases for bringing in denied claims. For example, seeing how they affect risk scores.

aneiderhiser commented 9 months ago

The KB link above broke w/ refactor - I think it's this now: https://thetuvaproject.com/knowledge-base/claims-data-fundamentals/adjustments-denials-reversals

bjakubowskiVNSNY commented 4 weeks ago

There are a few community use cases for bringing in denied claims. For example, seeing how they affect risk scores.

Seconding this -- denied claims are still potentially useful for risk scoring. As a potential Tuva adopter/contributor, would love to see this enhancement.