anesthesiologist deductible amount
anes_ded_amtDefinition
ISO-11179 Definition
The portion of anesthesiology service charges applied toward a member's annual deductible before insurance benefits are triggered. Captured during claims adjudication to accurately calculate member cost-sharing obligations and update accumulated deductible balances for anesthesia services.
Standard Abbreviation
anes_ded_amt
Category
Production DDL — FACT_CLAIM_HEADER
CREATE OR REPLACE TABLE FACT_CLAIM_HEADER (
clm_key INTEGER NOT NULL -- surrogate key,
clm_id VARCHAR(50) NOT NULL -- claim identifier,
mbr_key INTEGER NOT NULL -- FK to DIM_MEMBER,
prvdr_key INTEGER NOT NULL -- FK to DIM_PROVIDER,
clm_typ_cd VARCHAR(10) -- claim type code,
clm_stat_cd VARCHAR(10) -- claim status code,
svc_from_dt DATE -- service from date,
svc_to_dt DATE -- service to date,
diag_cd_1 VARCHAR(10) -- principal diagnosis,
proc_cd VARCHAR(10) -- procedure code,
clm_bill_amt DECIMAL(18,2) -- billed amount,
clm_alwd_amt DECIMAL(18,2) -- allowed amount,
clm_pd_amt DECIMAL(18,2) -- paid amount,
denial_rsn_cd VARCHAR(10) -- denial reason code,
load_dt TIMESTAMP_NTZ NOT NULL -- load timestamp
);
Standard Snowflake DDL for the canonical claims table. Convert to BigQuery or Databricks →
Why This Term Matters
Claims data is the financial backbone of the US healthcare system, and understanding claims terminology is essential for building accurate revenue cycle and reimbursement analytics. Data engineers who know this terminology can correctly parse 837 transactions, identify adjudication errors, and model denial patterns that represent real revenue recovery opportunities. A single misunderstood claims field can result in millions in underpayments identified only after external audits.
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