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financial counseling

fin_cnslng
finance·Updated Jun 23, 2026

Definition

ISO-11179 Definition

A patient-centered revenue cycle service that proactively educates patients about their healthcare financial obligations, available payment options, financial assistance programs, and insurance coverage details before or after receiving care to facilitate payment and prevent bad debt. Financial counseling is particularly important for high-balance accounts such as inpatient admissions, surgical procedures, and cancer treatments where patient out-of-pocket obligations may be substantial. Financial counselors review patient insurance benefits, calculate estimated patient responsibility, discuss payment plan options, screen for financial assistance and charity care eligibility, and help patients apply for Medicaid or marketplace coverage when appropriate.

Healthcare data teams measure financial counseling program effectiveness through point-of-service collection rates, payment plan enrollment rates, financial assistance application rates, and bad debt conversion rates comparing counseled versus non-counseled patient populations to demonstrate the financial return on financial counseling program investment.

Standard Abbreviation

fin_cnslng

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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