neurology coinsurance amount
neuro_coins_amtDefinition
ISO-11179 Definition
The member's percentage-based cost-sharing obligation for neurology specialty services covering diagnosis and treatment of nervous system disorders after the deductible is met. Captured in claims adjudication to determine member out-of-pocket costs for neurologist visits, EEGs, and related procedures.
Standard Abbreviation
neuro_coins_amt
Category
Production DDL — DIM_MEMBER
CREATE OR REPLACE TABLE DIM_MEMBER (
mbr_key INTEGER NOT NULL -- surrogate key,
mbr_id VARCHAR(50) NOT NULL -- member identifier,
mbr_first_nm VARCHAR(100) -- first name,
mbr_last_nm VARCHAR(100) -- last name,
mbr_birth_dt DATE -- date of birth,
mbr_gndr_cd CHAR(1) -- gender code M/F/U,
mbr_age SMALLINT -- age in years,
mbr_state_cd CHAR(2) -- state code,
mbr_zip_cd VARCHAR(10) -- zip code,
mbr_elig_ind BOOLEAN -- eligibility indicator,
mbr_enrl_dt DATE -- enrollment date,
mbr_term_dt DATE -- termination date,
mbr_plan_cd VARCHAR(20) -- plan code,
mbr_dual_elig_cd VARCHAR(10) -- dual eligibility code,
load_dt TIMESTAMP_NTZ NOT NULL -- load timestamp
);
Standard Snowflake DDL for the canonical member table. Convert to BigQuery or Databricks →
Why This Term Matters
Member and enrollment data governs who receives care and who pays for it — making it foundational to every downstream healthcare analytics workflow. Data engineers who understand member terminology build eligibility pipelines that prevent coverage gaps, correctly identify dual-eligible members, and support accurate risk adjustment submissions to CMS. Enrollment errors directly affect capitation payments and can trigger CMS corrective action plans.
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