computed concept · mined from SQL · flow
Coverage status
Derives Active / Inactive / Failed coverage from the eligibility result — the gate that decides who gets a letter.
Pipelines
20/53
compute it in SQL
Customers
13
EugeneGI, HeatonEye, MannEye, NWDerm, OneGI, OrthoAlliance…
Distinct SQL
24
distinct implementations
the SQL
Steps that compute it
The concrete SQL steps whose text computes coverage status, in plain language (✨ Gemini gloss), most-reused first. The count is how many steps across all trees run this same SQL; the link opens an example pipeline's task tree.
Loads insurance coverage status by calculating the latest eligibility transaction results for visits in the current batch.
Builds a temporary batch table to identify upcoming visits requiring initial or follow-up insurance eligibility and benefit verification.
Updates insurance coverage statuses by analyzing recent eligibility transactions and mapping results to standardized active or inactive states.
Flags upcoming visits for insurance eligibility checks based on service types, coverage status, and appointment lead times.
Flags visits for eligibility rechecks based on appointment lead time and previous transaction status to ensure coverage is verified.
Identifies visits requiring insurance eligibility checks or re-checks based on service types and proximity to the scheduled appointment date.
Updates insurance coverage statuses for visits by evaluating the latest eligibility transaction results and active status flags.
Calculates and loads the latest insurance eligibility status and coverage details for visits in the current batch.
Updates insurance coverage statuses by analyzing the latest eligibility transactions to determine if coverage is active, inactive, or errored.
Populates the temporary batch table with visit insurance details and flags records requiring new eligibility lookups based on current status.
Initializes the temporary batch table by identifying visits and insurance combinations that require eligibility verification based on business rules.
Updates the charge type dimension by mapping professional and facility fees to specific procedure codes, service types, and billing categories.
Updates insurance coverage status for visits by analyzing the latest eligibility transactions to determine if coverage is active or failed.
Builds the charge type catalog by categorizing professional and facility fees and generating encoded strings for billing and service types.
Populates primary and secondary insurance coverage status dimensions with standard values like active, inactive, or failed.
Updates the insurance coverage status table with the latest eligibility transaction results and active coverage indicators for each visit.
Updates insurance coverage status for visits by linking them to the most recent successful or failed eligibility verification transactions.
Loads comprehensive visit details including patient demographics, provider information, and insurance coverage status into a reporting table.
Updates the visit fact table with current status, letter activity, eligibility results, and payment totals for recent appointments.
Updates visit insurance coverage status by calculating the latest eligibility transaction results and mapping them to standardized status categories.
Flags visits requiring eligibility verification based on insurance details, service types, and scheduled appointment timing.
Updates insurance coverage statuses for visits by analyzing the most recent eligibility transaction results and error logs.
Identifies upcoming visits requiring insurance eligibility verification based on service types, appointment dates, and previous coverage status.
Augments the eligibility check batch with additional visits from specific source systems that lack recent or successful coverage verification.
who computes it · 20
Pipelines that compute coverage status
Grouped by product. Each links to its task tree.
| Customer | Pipeline | Product | Cadence |
|---|---|---|---|
| EugeneGI | Flow-MM-HL7-Processing | Flow | every 30m |
| EugeneGI | HL7-Processing-Nightly | Flow | daily 19:34 |
| MannEye | Flow-FHIR-Processing | Flow | every 10m |
| NWDerm | FHIR-Processing | Flow | every 2m |
| OneGI | Flow-ECW-Processing | Flow | daily 23:00 |
| OneGI | Flow-MM-Processing | Flow | daily 03:00 |
| OrthoAlliance | Flow-34792-Processing | Flow | every 5m |
| PAA | Daily-Processing | Flow | daily 11:15 |
| PAA | Daily-Processing-PAAMobile | Flow | daily 14:30 |
| PPRM | Daily-Visit-Processing | Flow | daily 05:00 |
| RIA | Flow-HL7-Processing | Flow | every 1m |
| RIA | Flow-HL7-Processing-AutoSendLettersForFutureVisits | Flow | daily 19:01 |
| SeaRad | Daily-Processing-Eligibility | Flow | monthly 00:30 |
| SeaRad | Daily-Visit-Processing | Flow | daily 22:15 |
| SeaRad | Daily-Visit-Processing-HL7 | Flow | every 10m |
| StrideCare | Flow-HL7-Processing | Flow | every 10m |
| SWOrofacial | Flow-HL7-Processing | Flow | every 10m |
| Wildflower | Flow-Processing | Flow | every 10m |
| HeatonEye | Daily-Processing | Mixed | daily 08:30 |
| OrthoAlliance | Daily-Accounts-Processing | RevFind | daily 09:15 |
the rhythm
When it runs
always-on loops · 9 · tick density = frequency
03691215182124
daily & monthly fires · 11
03691215182124
monthly 00:30
00:30 · 1st
daily 03:00
03:00
daily 05:00
05:00
daily 08:30
08:30
daily 09:15
09:15
daily 11:15
11:15
daily 14:30
14:30
daily 19:01
19:01
daily 19:34
19:34
daily 22:15
22:15
daily 23:00
23:00
HL7 FHIR file/batch eligibility◆ monthly · shaded = overnight (00–06)