Operations

Represents the aggregate number of records or data elements evaluated within a validation batch or process. Used in data quality reporting to measure the volume of claims, enrollment transactions, or clinical records subjected to validation rules and to calculate error rates and pass or fail ratios.

Classifies the category of validation being performed, such as format, referential integrity, business rule, or completeness check. Used in data governance workflows to organize and report on the variety of quality controls applied to claims, eligibility, pharmacy, or clinical data across healthcare information systems.

Specifies the unit of measure associated with a value being validated, such as days, dollars, milligrams, or service units. Used in claims and clinical data quality workflows to confirm that numeric fields carry appropriate and consistent units aligned with coding standards and payer or regulatory requirements.

Timestamp recording when a data validation record was last modified, capturing edits to validation rules, outcomes, or related metadata. Critical for audit trails in claims processing, member eligibility, and clinical data quality workflows to ensure compliance integrity.

Priority level assigned to a data validation process, indicating how quickly the validation must be completed. Used in claims adjudication, eligibility verification, and prior authorization workflows to triage pending validations and meet regulatory or contractual processing timelines.

Sequential version number assigned to a validation record, tracking iterations of rule changes, corrections, or reprocessing events. Supports audit compliance in claims adjudication and clinical data governance by identifying which validation logic version was applied.

Postal ZIP code associated with a data validation record, typically used to verify geographic accuracy of member addresses, facility locations, or service areas in eligibility, enrollment, and claims processing workflows within health plan systems.

Full address associated with a clinical or financial value record, used to identify the geographic location tied to a measurement, benefit, or service. Referenced in member enrollment, claims, and population health data to link values to specific service or coverage areas.

Current authorization state of a clinical or financial value record, indicating whether the value has been reviewed, approved, rejected, or is pending. Used in utilization management, claims adjudication, and care management workflows to control downstream processing decisions.

Dollar amount representing the billed or calculated charge associated with a specific clinical or financial value record. Captured in claims and billing systems to reflect the gross charge before adjustments, contractual allowances, or payer reimbursement are applied.

Date on which a specific clinical or financial value becomes active and applicable within a health plan or clinical system. Used in benefit configuration, fee schedule management, and contract pricing to determine which value applies during a given service or coverage period.

Patient Medical Record Number linked to a specific clinical or financial value record, serving as a unique identifier that connects the value to a patient's longitudinal health record across facilities, encounters, and care settings within the health system.

Calendar date on which a clinical measurement, assessment, or value-related activity is planned to occur. Used in care management, lab scheduling, and chronic disease monitoring workflows to coordinate data collection timing with patient encounters or treatment milestones.

Specific time of day at which a clinical measurement, assessment, or value-related activity is planned. Used alongside the scheduled date in care coordination and clinical operations systems to manage resource allocation and ensure timely data collection during patient encounters.

Street-level address component associated with a clinical or financial value record, capturing the physical location tied to a service, measurement, or benefit. Used in claims processing and member management systems to verify geographic eligibility and coordinate care delivery.

Unit of measure associated with a clinical or financial value, such as milligrams, days, visits, or dollars. Defines the scale or denomination of the value in clinical documentation, pharmacy dispensing, lab results, and benefit limit tracking within healthcare data systems.

Calendar date on which a data or identity verification activity is planned, such as eligibility confirmation, prior authorization review, or credential check. Used in health plan operations and care management workflows to track pending verifications against processing deadlines.

Time of day designated for a planned data or identity verification activity, such as a real-time eligibility check or authorization review. Used in health plan operations and clinical scheduling systems to coordinate verification tasks with staff availability and system processing windows.

Unit of measure or discrete item associated with a verification process, such as a single eligibility check, claim line, or credential document. Used to quantify and track verification workload in health plan operations, credentialing, and prior authorization processing systems.

The physical street address of the facility or location where a patient healthcare visit occurred, including clinic, hospital, or telehealth originating site. Stored in EHR, claims, and member systems, vst_addr is used for geographic analysis, provider network mapping, and validating place-of-service codes in claims data pipelines.