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Version: 3.0

Accuracy Scoring

Every rate column on every ROID row receives a numeric score (0–7) reflecting how trustworthy it is. Rate selection in Stage 7 simply picks the highest-scored non-NULL value per ROID.

Why Accuracy Scores Exist

Scenario A — Validated: Payer MRF reports $150 for CPT 99213 at Provider X. Hospital MRF independently reports $145. Agreement within ~3%. Both rates get score 7. Rate selection picks the payer rate.
Scenario B — Unvalidated: Payer MRF reports $150. No hospital MRF record for this ROID. Single-source rate within outlier bounds. Score 4. Usable, but will lose to any validated rate.
Scenario C — Outlier: Payer MRF reports $5,000 for a routine office visit. Medicare MPFS benchmark is $120. This is a 40x multiple — almost certainly a data error. Score 1. Rate selection deprioritizes this rate unless it's the only option.
The score system lets rate selection automatically prefer the most trustworthy value — no manual curation required.

Two Rounds of Scoring

1
Raw Accuracy (chunked by payer)
Runs immediately after combined_raw is built. Scores all raw and transformed rate columns. Computes payer_rates_array and hospital_rates_array for counterparty checking. Output is also used to filter long rates for imputation (only non-outlier rates feed in).
tmp_int_accuracy_raw
2
BRIT Combination
Benchmarks + Raw + Imputations + Transformations are merged into one wide table per ROID.
tmp_int_combined_brit
3
BRIT Accuracy (by rate/provider type)
Second scoring pass after BRIT is built. Separate SQL and criteria for Medical, Drugs, Labs, PG, DME, Urgent Care — each type has different outlier bounds and validation rules. Runs in parallel.
tmp_int_accuracy_brit_medical, _drugs, _labs, _physician_groups, _dme, _urgent_care
4
BRIT Accuracy Union
All type-specific BRIT accuracy tables merged into the final accuracy table.
tmp_int_accuracy_brit

Score Scale (0–7) vs Canonical Rate Score (1–5)

These are two different scales — a common point of confusion:

ScaleRangeWhere usedPurpose
Accuracy score0–7 (with decimal tiebreaker)Internal pipeline tables (_validation_score columns)Determines which rate wins in rate selection
Canonical rate score1–5Output tables (prod_combined_abridged, prod_combined_all)User-facing confidence indicator for the selected rate

The canonical rate score is a simplified translation of the winning rate's accuracy score — published so downstream users can filter by confidence without needing to understand the internal 0–7 system. The mapping is covered in the Score Hierarchy page.

roidpayer_idprovider_typebilling_codebill_typepayer_negotiated_ratepayer_negotiated_rate_validation_scorehospital_case_rate_dollarhospital_case_rate_dollar_validation_score
FBD5854D06F25705097C4C56643Physician Group19303Professional1004.735NULL0
3108DC6953FD17BA03C30837643Physician Group99214Professional85.515NULL0
250B15193710A188B35B7A41643Physician Group70100Professional26.404.111NULL0
56BC70BFF72949C6C3876F2F643Physician Group78315Professional260.135NULL0
5A1317CE5224B63D1D2FC6D9643Physician Group64640Professional203.545NULL0
DCA708CAFE5134D34884185F643Physician Group76937Professional33.985NULL0
159677123F4B57D67FDA374E643Physician Group55866Professional1975.255NULL0
07CF61EE18A87ECFE1BEF3E8643Physician Group76380Professional119.465NULL0
E11D8683BBD6F03C2CA80E34643Physician Group95925Professional81.795NULL0
16A6C472A1020588448B9C22643Physician Group44390Professional545.315NULL0