Candid Data ShareEncounters & Service Lines

export_financial_summary

Financial summary information including patient responsibility, copay, deductible, and coinsurance.

Primary Key: encounter_id

Identifiers

encounter_id
STRINGRequired

Unique ID associated with the encounter in the Candid system

claim_id
STRING

Unique Claim ID

Timestamps

updated_at
TIMESTAMP

Time when the financial summary tables are last updated based on claim status or transactions. NOTE: the updated_at field recalculates any time there is a claim status change and re-writes the data down, even though a claim status change is not balance impacting. This means the updated_at field may update in cases when claim statuses were changed, but no additional transactions were generated.

Organization

organization_id
STRING

User’s unique organization ID in the Candid system

organization_name
STRING

Organization Name

external_organization_id
STRING

Organization’s External ID - the ID that the organization uses to map to their own upstream system

Patient Information

patient_responsibility_cents
INTEGER

Patient responsibility in cents. Patient responsibility is calculated as the sum of PR-1 + PR-2 + PR-3 + PR-100.

patient_paid_amount_cents
INTEGER

Patient paid amount in cents

patient_adjustment_amount_cents
INTEGER

Patient adjustment / write-off amount in cents

patient_balance_amount_cents
INTEGER

Patient balance amount in cents. Patient Balance = claim balance only when responsible party is set to Patient. Patient balance = $0 otherwise.

Claim Information

claim_balance_amount_cents
INTEGER

Claim balance amount in cents. Balance = Billed Amount - Payments - Adjustments - Write-Offs

Financial

billed_amount_cents
INTEGER

Billed / charge amount in cents

allowed_amount_cents
INTEGER

Allowed amount in cents

insurance_paid_amount_cents
INTEGER

Insurance paid amount in cents

insurance_adjustment_amount_cents
INTEGER

Insurance adjustment / write-off amount in cents

copay_amount_cents
INTEGER

Copay amount (PR-3) in cents

deductible_amount_cents
INTEGER

Deductible amount (PR-1) in cents

coinsurance_amount_cents
INTEGER

Coinsurance amount (PR-2) in cents

insurance_write_off_amount_cents
INTEGER

Insurance write off amounts in cents (i.e. write offs applied to balances for Insurance Pay claims)

Other

is_persisted_financial_summary_record_stale
BOOLEAN

Indicates if there was a change made to the data for a given claim (ie next responsible party has been updated), but the financial data associated with it in our financial tables (which feed into the Financial Summary Table) has not been updated yet. The boolean flips to ‘yes’ the day the change is made, and then reset back to ‘no’ the next day once the financial tables are updated.