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charge capture

chrg_capt
finance·Updated Jun 13, 2026

Definition

ISO-11179 Definition

The process of accurately recording all billable healthcare services, supplies, and procedures delivered to a patient during a clinical encounter to ensure complete and compliant claim submission. Effective charge capture is the foundation of healthcare revenue integrity — services that are delivered but not captured result in permanent revenue loss that cannot be recovered after the timely filing deadline expires. Charge capture occurs through multiple mechanisms including automated charges triggered by orders in the electronic health record, manual charge entry by clinical staff, charge reconciliation comparing scheduled versus billed procedures, and charge capture audits identifying missing or undercoded services.

Healthcare data teams build charge capture analytics that compare volumes of ordered versus billed procedures by service type, identify providers with statistically low charge counts suggesting incomplete capture, and measure the revenue impact of charge capture improvement initiatives across clinical departments.

Standard Abbreviation

chrg_capt

Category

finance

Production DDL — FACT_CLAIM_TRANSACTION

FACT_CLAIM_TRANSACTION.sql
CREATE OR REPLACE TABLE FACT_CLAIM_TRANSACTION (
    clm_txn_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,
    tot_chrg_amt    DECIMAL(18,2)            -- total charged amount,
    tot_alwd_amt    DECIMAL(18,2)            -- total allowed amount,
    tot_pd_amt      DECIMAL(18,2)            -- total paid amount,
    cntrct_adj_amt  DECIMAL(18,2)            -- contractual adjustment,
    denial_ind      CHAR(1)                  -- denial indicator,
    denial_rsn_cd   VARCHAR(10)              -- denial reason code,
    prior_auth_nbr  VARCHAR(30)              -- authorization number,
    clm_lag_days    SMALLINT                 -- claim lag days,
    days_ar         SMALLINT                 -- days in AR,
    load_dt         TIMESTAMP_NTZ  NOT NULL  -- load timestamp
);

Standard Snowflake DDL for the canonical finance table. Convert to BigQuery or Databricks →

Why This Term Matters

Healthcare data terminology is foundational for any data engineer working in this industry. Precise understanding of standard terms enables accurate schema design, reduces downstream data quality issues, and ensures pipelines meet the regulatory and interoperability requirements imposed by HIPAA, HL7 FHIR, and CMS reporting frameworks. Without this foundation, even technically well-built pipelines produce data that fails validation when it reaches payers or regulators.

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