Revenue Cycle Certified

Claim grain revenue cycle dataset with payer, service line, billed, allowed and paid amounts, denials and days to pay. Source of the certified net collection rate, denial rate and days in AR metrics.

Product card

Version

2.1.0

Domain

Finance

Owner

Revenue Cycle Analytics

Steward

Maria Delgado

Sensitivity

Confidential business

Refresh

Daily 04:30

Rows

75,894

SQL endpoint

lakehouse.gold.dp_revenue_cycle

REST endpoint

/api/data-products/revenue-cycle/rows

Lineage inputs

silver.claim, silver.encounter, gold.dim_department, gold.metric_definitions

Consumers

Consumer type	Consumer
Power BI semantic model	Revenue Cycle (Direct Lake)
StrataJazz	Monthly cost and revenue feed
AI	Denial pattern assistant
Application	Payer contract review

Quality checks

Check	Result	Status
Row count greater than zero	75,894 rows	Passed
claim_id is never null	0 null	Passed
claim_id is unique	0 duplicates	Passed
Every row links to an enterprise patient	0 orphans	Passed

Schema (14 columns)

Column	Type	Nullable	Classification
`claim_id`	integer	YES
`encounter_id`	integer	YES
`enterprise_patient_id`	uuid	YES	Identifier
`payer`	text	YES
`service_line`	text	YES
`department`	text	YES
`claim_dt`	date	YES
`billed_amount`	numeric	YES	Financial
`allowed_amount`	numeric	YES	Financial
`paid_amount`	numeric	YES	Financial
`denied_flag`	boolean	YES
`denial_reason`	text	YES
`days_to_pay`	integer	YES
`paid_dt`	date	YES

Sample (8 rows)

claim_id	encounter_id	enterprise_patient_id	payer	service_line	department	claim_dt	billed_amount	allowed_amount	paid_amount	denied_flag	days_to_pay	paid_dt
544,458	147,264	aecfb3ae-4692-e18b-73c9-bad221b35fe5	Medicare	Medical Oncology	Thoracic Oncology	2014-06-27	281.75	119.75	113.43	False	58	2014-08-24
551,432	154,700	47cbe6b6-fa7a-e73f-1c87-85430df167f4	Self pay	Diagnostics	Diagnostic Imaging	2021-01-25	2,226.00	740.91	673.25	False	50	2021-03-16
552,065	155,368	15df5e28-fed6-c14e-ce22-683845482d16	Medicare	Medical Oncology	Breast Center	2012-10-17	269.50	110.96	101.28	False	25	2012-11-11
551,035	154,269	aab17330-93de-c027-27ef-de9e96979c25	Excellus BCBS	Medical Oncology	Melanoma and Skin Oncology	2014-05-22	307.05	181.85	170.92	False	20	2014-06-11
532,023	133,995	a1939dad-46ba-08c1-2aa7-5e9dfee43166	Medicare	Hematology	Lymphoma Center	2026-02-06	137.75	57.96	52.38	False	32	2026-03-10
511,768	112,521	cca00e55-97a3-e958-af3b-5a968a6615c2	Aetna	Medical Oncology	Melanoma and Skin Oncology	2023-06-28	367.13	231.86	211.86	False	33	2023-07-31
503,404	103,635	00476349-6076-b172-3cd7-1e744a4ae825	Medicare	Diagnostics	Diagnostic Imaging	2024-10-27	1,610.00	680.44	655.26	False	50	2024-12-16
573,719	178,467	c813616f-90e7-ced3-1333-e44c68b56a6e	Excellus BCBS	Infusion Services	Infusion Center	2015-03-02	1,247.85	693.10	609.58	False	34	2015-04-05