Batch / file feed · RevFind pipeline
OrthoAlliance · Daily-Accounts-Processing
Overall Processing job for Batch pipeline
trigger
How it's scheduled
The Batch / file feed arrives as a scheduled drop, so one overnight pass is enough: it ingests the day's file and works the whole batch to process the visits. A tighter loop would just re-scan the same file.
| Scheduled task | Cadence | Server | State | Coordination |
|---|---|---|---|---|
\MDC\Daily - Processing - OrthoAlliance | daily at 09:15 | prod-db-1 | enabled | standalone |
shape
The RevFind back-office spine
RevFind pipelines share a back-office shape: ingest → load accounts → reconcile remits → model contracts → surface underpayments. Lit stages are the ones this pipeline runs.
computed concepts · from the SQL
What it computes
Business concepts mined from this pipeline's SQL text — the meaning behind the typed steps. Each links to the concept lens (who else computes it).
Payers in SQLAnthemMedicare
task tree
What the pipeline runs
Tasks in order, each with what it does — typed stepsfrom the MDClarity task docs (click to open the reference), sub-jobsyou can expand inline (▶) to reveal their own tasks, and SQL steps summarized by Gemini (✨). Every step shows the tables it writes/reads and which earlier step it feeds from(sqlglot lineage).
Daily-Accounts-Processing
▶Process-NextGen-Data_ProcessDataFilesub-job · 14↗
- DownloadDownloadDownloads files from remote FTP or SFTP servers to local directories with support for archiving and parallel transfers.server=OrthoAlliance_ProdMirror-mdcssh-sftpremote directory=/local directory={SourceDataFolder}
▶Load-Adjustment_ProcessDataFilesub-job · 1↗
- Process ExportAdjustmentProcessFilewrites
ImportAdjustmentSourceAdjustmentfile path={FilePath}archive directory={SourceDataArchive}base table name=Adjustmentrow terminator=Newlinecolumn separator=Pipe
▶Load-Appointment_ProcessDataFilesub-job · 1↗
- Load ExportAppointmentProcessFilewrites
ImportAppointmentSourceAppointmentfile path={FilePath}archive directory={SourceDataArchive}base table name=Appointmentrow terminator=Newlinecolumn separator=Pipe
▶Load-Charge_ProcessDataFilesub-job · 1↗
- Load ExportChargeProcessFilewrites
ImportChargeSourceChargefile path={FilePath}archive directory={SourceDataArchive}base table name=Chargerow terminator=Newlinecolumn separator=Pipe
▶Load-ChargeMaster_ProcessDataFilesub-job · 1↗
- Load ExportChargemasterProcessFilewrites
ImportChargeMasterSourceChargeMasterfile path={FilePath}archive directory={SourceDataArchive}base table name=ChargeMasterrow terminator=Newlinecolumn separator=Pipe
▶Load-Encounter_ProcessDataFilesub-job · 1↗
- Load ExportEncounterProcessFilewrites
ImportEncounterSourceEncounterfile path={FilePath}archive directory={SourceDataArchive}base table name=Encounterrow terminator=Newlinecolumn separator=Pipe
▶Load-EncounterInsurancesub-job · 4↗
- Scan ExportEncounterInsuranceScanFiledisableddata file spec key=ImportEncounterInsurancefile path={FilePath}table name=ImportEncounterInsurancerow terminator=Newlinecolumn separator=Pipe
- Load ImportEncounterInsuranceLoadFilewrites
ImportEncounterInsurancedata file spec=ImportEncounterInsurancefile path={FilePath}import mode=Replacearchive file path={SourceDataArchive} - Create uci_ImportEncounterInsurancesql
load_encounterinsurance__create_uci_importencounterinsurance.sql✨ Builds a unique index on encounter insurance import data to optimize performance and ensure record uniqueness during processing.· readsImportEncounterInsurance↳ feeds from Load ImportEncounterInsurance - Delete/Insert SourceEncounterInsurancesql
load_encounterinsurance__delete_insert_sourceencounterinsurance.sql✨ Updates encounter insurance records while adjusting coordination of benefits logic to handle multiple insurance plans per patient visit.
▶Load-Event_ProcessDataFilesub-job · 1↗
- Load ExportEventProcessFilewrites
ImportEventSourceEventfile path={FilePath}archive directory={SourceDataArchive}base table name=Eventrow terminator=Newlinecolumn separator=Pipe
▶Load-Location_ProcessDataFilesub-job · 1↗
- Load ExportLocationProcessFilewrites
ImportLocationSourceLocationfile path={FilePath}archive directory={SourceDataArchive}base table name=Locationrow terminator=Newlinecolumn separator=Pipe
▶Load-Patient_ProcessDataFilesub-job · 1↗
- Load ExportPatientProcessFilewrites
ImportPatientSourcePatientfile path={FilePath}archive directory={SourceDataArchive}base table name=Patientrow terminator=Newlinecolumn separator=Pipe
▶Load-PatientInsurance_ProcessDataFilesub-job · 2↗
- PatientInsurance File CleanupExecuteProcesscommand=powershell.exe
- Load ExportPatientInsuranceProcessFilewrites
ImportPatientInsuranceSourcePatientInsurancefile path={FilePath}archive directory={SourceDataArchive}base table name=PatientInsurancerow terminator=Newlinecolumn separator=Pipe
▶Load-Payer_ProcessDataFilesub-job · 1↗
- Load ExportPayerProcessFilewrites
ImportPayerSourcePayerfile path={FilePath}archive directory={SourceDataArchive}base table name=Payerrow terminator=Newlinecolumn separator=Pipe
▶Load-Provider_ProcessDataFilesub-job · 1↗
- Load ExportProviderProcessFilewrites
ImportProviderSourceProviderfile path={FilePath}archive directory={SourceDataArchive}base table name=Providerrow terminator=Newlinecolumn separator=Pipe
▶Load-TransactionDetail_ProcessDataFilesub-job · 1↗
- Process ExportTransactionDetail DataFileProcessFilewrites
ImportTransactionDetailSourceTransactionDetailfile path={FilePath}archive directory={SourceDataArchive}base table name=TransactionDetailrow terminator=Newlinecolumn separator=Pipe
▶Load-Entitiessub-job · 2↗Load Facility, Provider
- Load FacilityLoadEntitieswrites
Facility· readsSourceLocationfacilityentity type=Facilitycustom query - Load Providersql
load_entities__load_provider.sql✨ Synchronizes provider master data including taxonomy codes and NPIs for all active rendering providers in the system.writesProvider· readsProviderTaxonomySourceAppointmentSourceEncounterSourceProvider
▶Load-InsuranceMapsub-job · 3↗
- Imports delimited data files into database tables using predefined specifications for validation, loading, and optional file archiving.writes
ImportInsuranceMapdata file spec=ImportInsuranceMapimport mode=ReplaceDISABLED - Load InsuranceMap Table - OldLoadEntitiesdisabledwrites
InsuranceMap· readsImportInsuranceMapInsuranceMapentity type=InsuranceMapcustom queryDISABLED - Load InsuranceMap TableLoadEntitieswrites
InsuranceMap· readsInsuranceMapSourcePayerentity type=InsuranceMapcustom querykey prefix=IM
▶Load-Account-Transform-Tablessub-job · 12↗NextGen Transforms
- Create AccountDeltasql
load_account_transform_tables__create_accountdelta.sql✨ Identifies encounters updated since the last pipeline run to create a delta list of accounts requiring transformation and loading. - Load TransformTransactionsql
load_account_transform_tables__load_transformtransaction.sql✨ Categorizes and loads raw transaction data into a standardized format for accounts identified in the current processing delta.writesTransformTransaction· readsAccountDelta - Load TransformRemitAdjustmentsql
load_account_transform_tables__load_transformremitadjustment.sql✨ Builds the remittance adjustment transformation table by categorizing insurance denials and mapping reason codes to standardized adjustment types.writesTransformRemitAdjustment· readsAccountDelta - Load TransformChargesql
load_account_transform_tables__load_transformcharge.sql✨ Loads detailed charge information, including service dates, procedure codes, and balances, for encounters identified in the current processing delta.writesTransformCharge· readsAccountDeltaSourceCharge - Load TransformAccountsql
load_account_transform_tables__load_transformaccount.sql✨ Builds account-level summaries by mapping encounter status, payer information, and total balances for updated patient accounts.writesTransformAccount· readsAccountDeltaSourceEncounter - Load TransformRemitsql
load_account_transform_tables__load_transformremit.sqldisabled✨ Builds the remit transformation table by consolidating electronic remittance advice adjustments and transaction-level payment data for updated encounters.writesTransformRemit· readsEncounterDeltaTransformRemitTransformRemitAdjustmentTransformTransactionPaymentAdjustment - Create TempZeroBalanceDatesql
load_account_transform_tables__create_tempzerobalancedate.sqldisabled✨ Calculates the specific date an encounter reached a zero balance by comparing cumulative transaction amounts against total charges.writesTempZeroBalanceDate· readsEncounterDeltaSourceTransactionDetailTransformAccountCharge - Load TransformRemitOrdersql
load_account_transform_tables__load_transformremitorder.sqldisabled✨ Determines the sequence of insurance remittances for each account to identify initial, current, and post-zero-balance payment activities.writesTransformRemitOrder· readsEncounterDeltaTempZeroBalanceDateTransformRemitTransformRemitOrder - ?? Load TransformPatientResponsibilityChargessql
load_account_transform_tables__load_transformpatientresponsibilitycharges.sqldisabled✨ Flags specific charges as patient responsibility based on source system indicators and insurance remittance transfer records.writesTransformPatientResponsibilityCharge· readsEncounterDeltaSourceEncounterTransformAccountChargeTransformPatientResponsibilityChargeTransformRemit - Load TransformRemitAdjustmentAggregatesql
load_account_transform_tables__load_transformremitadjustmentaggregate.sql✨ Aggregates remittance adjustments to calculate total contract, patient, and denial amounts at the charge level for updated accounts.writesTransformRemitAdjustmentAggregate· readsAccountDeltaTransformChargeTransformRemitAdjustment↳ feeds from Load TransformCharge, Load TransformRemitAdjustment - Load TransformChargeTransactionMeasuressql
load_account_transform_tables__load_transformchargetransactionmeasures.sql✨ Builds aggregated financial measures for charges, including payments, adjustments, and denials, for encounters identified in the current processing delta.writesTransformChargeTransactionMeasure· readsAccountDeltaSourceEncounterTransformChargeTransformRemitAdjustmentAggregateTransformTransaction↳ feeds from Load TransformCharge, Load TransformRemitAdjustmentAggregate, Load TransformTransaction - Load TransformPatientsql
load_account_transform_tables__load_transformpatient.sql✨ Updates or inserts patient demographic information and contact details into the transform layer based on the latest source system records.writesTransformPatient· readsSourcePatient
▶Load-Charge-Dimensionsub-job · 11↗
- Load TempChargeSchedulessql
load_charge_dimension__load_tempchargeschedules.sql✨ Builds temporary charge schedules by calculating effective date ranges for professional and facility fee schedules from the master charge list.writesTempChargeSchedules - Merge TransformChargemasterMergeSqlwrites
TransformChargemaster· readsSourceChargeMastermerge data source type=ThisDatabasetable name=TransformChargemastermerge mode=InsertUpdatebulk copy timeout seconds=300bulk copy use table lock - Load FeeScheduleRecordsql
load_charge_dimension__load_feeschedulerecord.sql✨ Loads fee schedule records by mapping charge codes and modifiers to specific pricing schedules for professional and facility services.writesFeeScheduleRecord· readsSourceChargeMasterTempChargeSchedules↳ feeds from Load TempChargeSchedules - Load ScheduleMapsql
load_charge_dimension__load_schedulemap.sql✨ Maps fee schedules to specific facilities and insurance types to define pricing applicability across the organization.writesScheduleMap· readsFacilityTempChargeSchedules↳ feeds from Load TempChargeSchedules - Load ContractMapsql
load_charge_dimension__load_contractmap.sqldisabled✨ Updates the contract map to define fee logic and billing types for facilities and professional services.writesContractMap· readsFacility - Load ScheduleLoadEntitieswrites
Schedule· readsTempChargeSchedules↳ feeds from Load TempChargeSchedulesentity type=Schedulecustom query - Load DMECurrentCodes Tablesql
load_charge_dimension__load_dmecurrentcodes_table.sql✨ Identifies and stores currently active Medicare Durable Medical Equipment procedure codes based on effective date ranges.writesDMECurrentCodes - Load ChargeTypesql
load_charge_dimension__load_chargetype.sql✨ Builds the charge type catalog by categorizing professional and facility fees and generating encoded strings for billing and service types. - Load ChargeType Dimensionsql
load_charge_dimension__load_chargetype_dimension.sql✨ Populates the charge type dimension with members and their corresponding CPT categories to support hierarchical reporting.writesDimensionMember· readsChargeType - Load ProcedureCode Dimensionsql
load_charge_dimension__load_procedurecode_dimension.sql✨ Builds the procedure code dimension by extracting codes from charge types and mapping them to standard descriptions and categories.writesDimensionMember· readsChargeTypeDimensionMemberProcedureCode↳ feeds from Load ChargeType Dimension, Load ProcedureCategory and Subcategory DM - Load ProcedureCategory and Subcategory DMsql
load_charge_dimension__load_procedurecategory_and_subcategory_dm.sql✨ Builds the procedure category dimension by extracting unique parent groupings from existing procedure code members.writesDimensionMember· readsDimensionMember↳ feeds from Load ChargeType Dimension, Load ProcedureCode Dimension
▶Load-Patients-Entitysub-job · 1↗
- Execute LoadPatientsLoadPatientsUpsert patient records into the patient dimension.· reads
PatientTransformPatientcustom patient query
▶Load-Account-Datasub-job · 11↗Load Account-Level Tables
- Load AccountChargesql
load_account_data__load_accountcharge.sql✨ Calculates financial metrics for individual charges and loads detailed charge records for accounts identified in the current delta.writesAccountChargeChargeMeasures· readsAccountDeltaChargeMeasuresChargeTypePatientProviderTransformAccountTransformCharge - Load Accountsql
load_account_data__load_account.sql✨ Aggregates financial totals and denial categories to build account-level records, including insurance mapping and age-based plan logic.writesAccount· readsAccountChargeAccountDeltaAccountDetailInsuranceMapPatientSourceEncounterInsuranceTransformAccountTransformChargeTransactionMeasure↳ feeds from Load AccountCharge, Load AccountDetail - Load AccountRemitsql
load_account_data__load_accountremit.sql✨ Consolidates insurance remittance advice and posted transaction details into a unified table for account-level payment and adjustment tracking.writesAccountRemit· readsAccountDeltaSourcePayerTransformChargeTransformRemitAdjustmentTransformTransaction ▶Load-Dimension-Memberssub-job · 19↗
- Load Insurance Dimensionsql
load_dimension_members__load_insurance_dimension.sql✨ Loads the insurance dimension with unique insurance keys and a placeholder for unmapped records to support payer-level analysis.writesDimensionMember· readsInsurance - Load EligibilityInsurance Dimensionsql
load_dimension_members__load_eligibilityinsurance_dimension.sql✨ Loads insurance members that support electronic eligibility and benefits verification via API integration.writesDimensionMember· readsDimensionMemberInsurance↳ feeds from Load AllowedStatus Dimension, Load DenialCategory Dimension, Load DiagnosisCode Dimension, Load Facility Dimensions, Load FacilityGroup Dimensions, Load FacilityType Dimensions, Load Insurance Dimension, Load Modifier Dimension, Load PlaceOfService Dimensions, Load Provider Dimension, Load ProviderType Dimension, Load QuoteInsurance Dimension, Load State Dimension, Load Time Dimensions, Load VisitStatus Dimension, Load VisitType Dimensions - Load QuoteInsurance Dimensionsql
load_dimension_members__load_quoteinsurance_dimension.sql✨ Builds a dimension of insurance providers associated with active contracts to facilitate accurate patient cost estimates.writesDimensionMember· readsContractMapInsurance - Load Time Dimensionssql
load_dimension_members__load_time_dimensions.sql✨ Builds time-based dimension members for days, months, and years to support temporal reporting across the pipeline.writesDimensionMember· readsTransformVisit - Load VisitStatus Dimensionsql
load_dimension_members__load_visitstatus_dimension.sql✨ Loads appointment status values into the visit status dimension to track patient encounter progress.writesDimensionMember· readsTransformVisit - Load DenialCategory Dimensionsql
load_dimension_members__load_denialcategory_dimension.sql✨ Loads denial category dimensions from adjustment code rollup data to categorize claim denials.writesDimensionMember· readsAdjustmentCodeRollup - Load Provider Dimensionsql
load_dimension_members__load_provider_dimension.sql✨ Loads provider dimension members and their classifications into the central dimension table for reporting and filtering.writesDimensionMember· readsProvider - Load ProviderType Dimensionsql
load_dimension_members__load_providertype_dimension.sql✨ Builds the provider type dimension by extracting unique parent categories from existing provider dimension records.writesDimensionMember· readsDimensionMember↳ feeds from Load AllowedStatus Dimension, Load DenialCategory Dimension, Load DiagnosisCode Dimension, Load EligibilityInsurance Dimension, Load Facility Dimensions, Load FacilityGroup Dimensions, Load FacilityType Dimensions, Load Insurance Dimension, Load Modifier Dimension, Load PlaceOfService Dimensions, Load Provider Dimension, Load QuoteInsurance Dimension, Load State Dimension, Load Time Dimensions, Load VisitStatus Dimension, Load VisitType Dimensions - Load Facility Dimensionssql
load_dimension_members__load_facility_dimensions.sql✨ Builds facility dimension members by mapping source locations to specific regional and ownership categories for organizational reporting.writesDimensionMember· readsSourceLocationSourceLocationMap - Load FacilityGroup Dimensionssql
load_dimension_members__load_facilitygroup_dimensions.sql✨ Builds the facility group dimension by extracting unique parent identifiers from existing facility records.writesDimensionMember· readsDimensionMember↳ feeds from Load AllowedStatus Dimension, Load DenialCategory Dimension, Load DiagnosisCode Dimension, Load EligibilityInsurance Dimension, Load Facility Dimensions, Load FacilityType Dimensions, Load Insurance Dimension, Load Modifier Dimension, Load PlaceOfService Dimensions, Load Provider Dimension, Load ProviderType Dimension, Load QuoteInsurance Dimension, Load State Dimension, Load Time Dimensions, Load VisitStatus Dimension, Load VisitType Dimensions - Load FacilityType Dimensionssql
load_dimension_members__load_facilitytype_dimensions.sql✨ Loads unique facility types into the dimension table to allow for the categorization of different healthcare service locations.writesDimensionMember· readsFacility - Load Practice Dimensionssql
load_dimension_members__load_practice_dimensions.sqldisabled✨ Loads practice dimension members from the practice map for entities that have associated encounter records.writesDimensionMember· readsPracticeMapsourceencounter - Load PlaceOfService Dimensionssql
load_dimension_members__load_placeofservice_dimensions.sql✨ Loads the place of service dimension by synchronizing standardized facility codes and names from common reference data.writesDimensionMember· readsPOSCodes - Load VisitType Dimensionssql
load_dimension_members__load_visittype_dimensions.sql✨ Loads unique visit type dimension members from appointment data to standardize encounter classifications across the system.writesDimensionMember· readsHL7Visit - Load AccountStatus Dimensionsql
load_dimension_members__load_accountstatus_dimension.sqldisabled✨ Updates account status dimensions using encounter status information to track the lifecycle of patient accounts.writesDimensionMember· readsSourceEncounter - Load AllowedStatus Dimensionsql
load_dimension_members__load_allowedstatus_dimension.sql✨ Builds allowed status dimensions to categorize how actual payments compare to expected insurance contract rates.writesDimensionMember - Load DiagnosisCode Dimensionsql
load_dimension_members__load_diagnosiscode_dimension.sql✨ Builds diagnosis code dimensions by extracting codes from account charges and mapping them to standardized medical categories.writesDimensionMember· readsAccountChargeDimensionMember↳ feeds from Load AllowedStatus Dimension, Load DenialCategory Dimension, Load EligibilityInsurance Dimension, Load Facility Dimensions, Load FacilityGroup Dimensions, Load FacilityType Dimensions, Load Insurance Dimension, Load Modifier Dimension, Load PlaceOfService Dimensions, Load Provider Dimension, Load ProviderType Dimension, Load QuoteInsurance Dimension, Load State Dimension, Load Time Dimensions, Load VisitStatus Dimension, Load VisitType Dimensions - Load Modifier Dimensionsql
load_dimension_members__load_modifier_dimension.sql✨ Loads the procedure modifier dimension by extracting unique codes from account charges and mapping them to their descriptive labels.writesDimensionMember· readsAccountChargeProcedureModifier - Load State Dimensionsql
load_dimension_members__load_state_dimension.sql✨ Updates state dimensions using facility location data to allow for geographic segmentation of healthcare services and revenue.writesDimensionMember· readsFacility
- Clean Estimatessql
load_account_data__clean_estimates.sql✨ Removes outdated non-scenario insurance estimates and associated charge calculations for encounters identified in the delta table.writesAccountEstimateAccountEstimateCalculationAccountEstimateCharge· readsAccountEstimateEncounterDelta ▶Score-Accountssub-job · 9↗
- Score AetnaBatchProcessAccountswrites
AccountEstimate· readsQuoteBatchVisitBatchmin service date=2022-07-01incremental - Score AnthemBatchProcessAccountswrites
AccountEstimate· readsQuoteBatchVisitBatchmin service date=2022-01-01incremental - Score CignaBatchProcessAccountswrites
AccountEstimate· readsQuoteBatchVisitBatchmin service date=2022-01-01incremental - Score Humana MedicareBatchProcessAccountswrites
AccountEstimate· readsQuoteBatchVisitBatchmin service date=2022-01-01incremental - Score MedicareBatchProcessAccountswrites
AccountEstimate· readsQuoteBatchVisitBatchmin service date=2023-01-01incremental - Score MMOBatchProcessAccountswrites
AccountEstimate· readsQuoteBatchVisitBatchmin service date=2023-03-01incremental - Score UHCBatchProcessAccountswrites
AccountEstimate· readsQuoteBatchVisitBatchmin service date=2022-08-01incremental - BatchProcessAccountDataBatchProcessAccountDataCalculates patient account estimates across multiple facilities and insurance types to update pricing after contract or configuration changes.writes
AccountEstimate· readsQuoteBatchVisitBatchmin service date=2023-01-01incremental - BatchProcessAccountData (Catch All)BatchProcessAccountswrites
AccountEstimate· readsQuoteBatchVisitBatchincremental
▶Load-Custom-Propertiessub-job · 2↗Load custom properties from Load-Visits
- UpdateVisitCustomPropertyFromQueryUpdateVisitCustomPropertyFromQuerydisabled· reads
InsuranceSearch_ResultTransformVisitInsuranceCoverageStatusVisitBatchcustom visit update custom property queryDISABLED - LoadCustomNotesCustomPropertyLoadCustomNotesCustomPropertydisabled· reads
BundleNotesMappingHL7DeltaHL7VisitVisitBatchentity=Visitcustom property key=CustomNotescustom querybatch modeDISABLED
- Load AccountDetailsql
load_account_data__load_accountdetail.sql✨ Builds a comprehensive account summary by joining patient, insurance, and financial data to track balances, denials, and estimated opportunities.writesAccountDetail· readsAccountAccountChargeAccountDeltaAccountEstimateDimensionMemberPatientSourceEncounterInsuranceSourcePayer↳ feeds from Clean Estimates, Load Account, Load AccountCharge - Load AccountChargeDetailsql
load_account_data__load_accountchargedetail.sql✨ Loads granular charge-level details, including procedure codes, modifiers, and provider information, for comprehensive reporting on account financial activity.writesAccountChargeDetail· readsAccountAccountChargeAccountDeltaAccountEstimateCalculationAccountEstimateChargeDimensionMemberPatientSourceEncounterInsurance↳ feeds from Clean Estimates, Load Account, Load AccountCharge - Update Modifier 22 Custom PropertyUpdateCustomPropertyFromQuery· reads
AccountChargeAccountDelta↳ feeds from Load AccountChargeentity=Accountcustom property key=Modifier22custom query
▶Update-Dashboard-Tablessub-job · 2↗
▶Load-Visit-Factsub-job · 1↗
- Load VisitFactsql
load_visit_fact__load_visitfact.sql✨ Refreshes the visit fact table by recalculating metrics for encounters with recent updates, payments, eligibility checks, or patient communications.writesVisitFact· readsEligibilityStatusMapEligibilityTxnPatientLetterPaymentTxnVisit
- UpdateDashboardTablesUpdateDashboardTablesRegenerates optimized aggregate tables for all dashboard reports and updates their definitions to reflect the latest source data.
- Data-Integrity-Reportsub-job