computed concept · mined from SQL · revfind
Fee schedule / contract
Loads fee schedules / contracted rates for expected-reimbursement modeling.
Pipelines
15/53
compute it in SQL
Customers
11
CCP, Commonwealth, ECP, HeatonEye, MNEye, OrthoAlliance…
Distinct SQL
32
distinct implementations
the SQL
Steps that compute it
The concrete SQL steps whose text computes fee schedule / contract, 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.
Updates the master transaction table with new or modified records from the imported transaction data.
Updates the charge transaction table by filtering and synchronizing charge-type records from the main transaction source.
Updates the payment transaction table by filtering and synchronizing payment-type records from the main transaction source.
Updates the adjustment transaction table by filtering and synchronizing adjustment-type records from the main transaction source.
Updates the transfer transaction table by filtering and synchronizing transfer-in and transfer-out records from the main transaction source.
Updates the source fee schedule procedure table with the latest pricing and procedure code mappings from imported data.
Updates the source fee schedule headers with current names, insurance package links, and effective dates from imported data.
Builds the charge master by joining fee schedules and procedure codes to maintain standard pricing and modifier details.
Loads detailed fee schedule records by mapping chargemaster prices to specific codes and modifiers for professional and facility schedules.
Loads fee schedule records with charge codes, modifiers, and pricing for specific professional and facility practice schedules.
Categorizes charge types by mapping procedure codes, modifiers, and service types from the fee schedule and charge data.
Builds the end-to-end mapping between chargemaster schedules, facilities, and insurance records for fee calculation.
Loads fee schedule records with specific amounts and modifier filters based on practice-specific chargemaster data and schedules.
Loads fee schedule records by mapping charge codes and modifiers to specific pricing schedules for professional and facility services.
Builds a mapping of fee schedules to departments, identifying self-pay and chargemaster designations from source payer and schedule data.
Builds a transformed charge master table by calculating effective pricing and anesthesia status from fee schedules and charge types.
Loads fee schedule data into the source table, formatting procedure codes and updating records based on unique identifiers.
Synchronizes the charge type table by merging fee schedule and bundle data to define professional billing codes and descriptions.
Calculates surgical CPT rates and units for standard data sources using fee schedules and bundled service logic.
Calculates surgical CPT rates and units specifically for Edgewater source data using fee schedules and bundled service logic.
Calculates surgical CPT rates and units for mobile source data using fee schedules and bundled service logic.
Calculates surgical CPT rates and units for Meditech source data using fee schedules and bundled service logic.
Loads regional Medicaid fee schedules and schedule mappings into the system for non-hospital facilities and specific service types.
Loads Medicare Durable Medical Equipment fee schedules and facility mappings for the specified state into the system.
Loads Medicare drug fee schedules and facility mappings into the system based on current Medicare pricing data.
Calculates and loads Medicare clinic fee schedules based on Relative Value Units and regional conversion factors.
Builds and updates Medicare RVU fee schedules and facility mappings for hospital-based services using regional zip code data.
Builds a temporary mapping table that identifies and categorizes fee schedules as either self-pay or chargemaster for specific departments.
Loads chargemaster rates and facility mappings into the system to define standard billing amounts for medical procedures.
Loads self-pay fee schedules and facility mappings to establish fixed pricing for patients without insurance coverage.
Refines visit charges by deduplicating evaluation and management codes based on price rankings from the self-pay fee schedule.
Loads fee schedule records with pricing, modifiers, and priority levels mapped from various source chargemasters and temporary schedules.
who computes it · 15
Pipelines that compute fee schedule / contract
Grouped by product. Each links to its task tree.
| Customer | Pipeline | Product | Cadence |
|---|---|---|---|
| PAA | Daily-Processing | Flow | daily 11:15 |
| PAA | Daily-Processing-PAAMobile | Flow | daily 14:30 |
| SeaRad | Daily-Visit-Processing | Flow | daily 22:15 |
| SeaRad | Daily-Visit-Processing-HL7 | Flow | every 10m |
| SunLife | Daily-Visits-Processing | Flow | daily 10:30 |
| HeatonEye | Daily-Processing | Mixed | daily 08:30 |
| CCP | Daily-Accounts-Processing | RevFind | daily 04:30 |
| Commonwealth | Cutover-Daily-Accounts-Processing | RevFind | daily 02:30 |
| Commonwealth | Daily-Accounts-Processing | RevFind | daily 00:30 |
| ECP | Daily-Accounts-Processing-RevFind | RevFind | daily 01:00 |
| OrthoAlliance | Daily-Accounts-Processing | RevFind | daily 09:15 |
| OrthoAlliance | RevFind-SBO-Daily-Processing-Accounts | RevFind | daily 09:15 |
| StrideCare | RevFind-Daily-Processing-Accounts-33143 | RevFind | daily 02:00 |
| USHP | RevFind-Daily-Processing-Accounts | RevFind | daily 06:45 |
| MNEye | Daily-Processing-Source-Data | Utility | daily 03:15 |
the rhythm
When it runs
always-on loops · 1 · tick density = frequency
03691215182124
daily & monthly fires · 13
03691215182124
daily 00:30
00:30
daily 01:00
01:00
daily 02:00
02:00
daily 02:30
02:30
daily 03:15
03:15
daily 04:30
04:30
daily 06:45
06:45
daily 08:30
08:30
daily 09:15
09:15
daily 10:30
10:30
daily 11:15
11:15
daily 14:30
14:30
daily 22:15
22:15
HL7 FHIR file/batch eligibility◆ monthly · shaded = overnight (00–06)