Data Ingestion Release 2.4

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Data Ingestion - Claims Release Notes 2.4


  1. Preprocessing changes to client-specific environments to include the name logic. Some clients were using the patient full name, enhanced to use the First name and Last name columns per data guide.
  2. client-specific preprocessing changes
  3. SHIR archival changes to the preprocessing.


  1. Add email to the patient resources


  1. Remove history from Beneficiary
  2. Added system and code in type->coverage
  3. Removed version append in beneficiary


N/A in this release


N/A in this release

Explanation of Benefits

  1. Enhanced Care Team in EOB Pharmacy
  2. Billable period fix for inpatient and outpatient EOB profiles
  3. Included / modified the Claim site of service network status & Claim prescribing provider network status element in all EOBs (inpatient, outpatient, professional and pharmacy)
  4. EOB - Care team Attending provider changes
  5. Bill Type and Category code changes (category.code -> typeofbill (inpatient, outpatient, Professional, Pharmacy)) (see image below)

    json extract

  6. Procedure type added (procedure.type.procedure type) (Pic below)
  7. Claim payment denial code and line payment denial code maps to the same location. Changes made to refer appropriate locations.
  8. Modifier changes
  9. Modified benefit to line payment amount.
  10. Add text ‘denial reason’ to reason.text (the whole value won’t show up when not decimal in input file)
  11. Allowed number of units

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