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collections

collectns
finance·Updated Jun 13, 2026

Definition

ISO-11179 Definition

The systematic process of pursuing payment for outstanding healthcare accounts receivable from insurance payers, patients, or responsible parties through follow-up activities including claim resubmission, appeals, statement generation, payment plan arrangements, and third-party collection agency placement. Effective collections management requires a structured workflow that assigns accounts to collectors based on payer type and balance size, establishes follow-up schedules for each account category, tracks all collection activities in the patient accounting system, and escalates unresolved balances through defined collection stages. Healthcare data teams build collections analytics that measure collector productivity by accounts worked and dollars recovered, track collection rates by payer and balance age, analyze payment pattern trends to optimize follow-up timing, and calculate the return on investment of different collection strategies including internal follow-up versus collection agency placement.

Standard Abbreviation

collectns

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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