{% set payer_spine_cols = cld_params.PAYER_SPINE_COLS %}
{% set network_spine_cols = cld_params.NETWORK_SPINE_COLS %}
{% set prov_spine_cols = cld_params.PROV_SPINE_COLS %}
{% set code_spine_cols = cld_params.CODE_SPINE_COLS %}
{% set gross_charges = cld_params.GROSS_CHARGE_COLS + cld_params.GROSS_CHARGE_STATS %}
{% set cash_charges = cld_params.CASH_COLS %}
{% set payer_raw_cols = cld_params.PAYER_RAW_COLS %}
{% set payer_transformation_cols = cld_params.PAYER_TRANSFORMATION_COLS %}
{% set hospital_raw_cols = cld_params.HOSPITAL_RAW_COLS %}
{% set hospital_transformation_cols = cld_params.HOSPITAL_TRANSFORMATION_COLS %}
{% set imputation_cols = cld_params.IMPUTATION_COLS %}
{% set original_nontransformed_cols = cld_params.ORIGINAL_NONTRANSFORMED_COLS %}
{% set transformation_utils = cld_params.TRANSFORMATION_COLS %}
{% set benchmark_cols = cld_params.BENCHMARK_COLS %}
{% set outlier_bounds = cld_params.OUTLIER_BOUNDS %}
{% set original_billing_code_maps = cld_params.ORIGINAL_BILLING_CODE_MAPS %}
{% set original_billing_code_type_maps = cld_params.ORIGINAL_BILLING_CODE_TYPE_MAPS %}
{% set non_transformed_column_maps = cld_params.NON_TRANSFORMED_COLUMN_MAPS %}
{% set imputation_stats = cld_params.IMPUTATION_STATS_COLS %}
{% set ip_rate_cols = cld_params.INPATIENT_COLS_FULL %}
{% set non_ip_rate_cols = cld_params.NON_INPATIENT_COLS_FULL %}
{% for col in ip_rate_cols %}
{% endfor %}
{% set ip_rate_cols_no_impute = cld_params.INPATIENT_COLS_RAW_TRANSFORM %}
{% set non_ip_rate_cols_no_impute = cld_params.NON_INPATIENT_COLS_RAW_TRANSFORM %}
{% set source_mapping = {} %}
{% for col in hospital_raw_cols + hospital_transformation_cols + payer_raw_cols + payer_transformation_cols %}
{% if col.startswith("payer") %}
{% set _ = source_mapping.update({col: "payer"}) %}
{% elif col.startswith("hosp") or col.startswith("drug") %}
{% set _ = source_mapping.update({col: "hospital"}) %}
{% endif %}
{% endfor %}
{% for col in imputation_cols %}
{% set _ = source_mapping.update({col: "imputation"}) %}
{% endfor %}
{% set rate_type_mapping = {} %}
{% for col in hospital_raw_cols + payer_raw_cols %}
{% set _ = rate_type_mapping.update({col: "raw: " + col}) %}
{% endfor %}
{% for col in hospital_transformation_cols + payer_transformation_cols %}
{% set _ = rate_type_mapping.update({col: "transform: " + col}) %}
{% endfor %}
{% for col in imputation_cols %}
{% set _ = rate_type_mapping.update({col: "impute: " + col}) %}
{% endfor %}
{% set methodology_mapping = {} %}
{% for col in hospital_raw_cols + payer_raw_cols +
hospital_transformation_cols + payer_transformation_cols + imputation_cols %}
{% if 'case_rate' in col or 'base_rate' in col or 'cstm_negotiated_rate' in col %}
{% set _ = methodology_mapping.update({col: "Case Rate"}) %}
{% endif %}
{% if
('hospital_perc' in col) or
('payer_' in col and 'perc_to_dol' in col) or
(col.startswith('cstm_') and 'perc_to_dol' in col) or
(col.startswith('rc_') and 'perc_to_dol' in col) or
(col.startswith('op_') and 'perc_to_dol' in col)
%}
{% set _ = methodology_mapping.update({col: "Percent of Total Billed Charges"}) %}
{% endif %}
{% if 'fee_schedule' in col %}
{% set _ = methodology_mapping.update({col: "Fee Schedule"}) %}
{% endif %}
{% endfor %}
{% set rate_class_mapping = {} %}
{% for col in hospital_raw_cols + payer_raw_cols %}
{% set _ = rate_class_mapping.update({col: "Raw"}) %}
{% endfor %}
{% for col in hospital_transformation_cols + payer_transformation_cols %}
{% set _ = rate_class_mapping.update({col: "Transform"}) %}
{% endfor %}
{% for col in imputation_cols %}
{% set _ = rate_class_mapping.update({col: "Impute"}) %}
{% endfor %}
{% set imputation_method_mapping = {} %}
{% for col in imputation_cols %}
{% if "msdrg_mrf_base" in col %}
{% set _ = imputation_method_mapping.update({col: "MRF-Reported Base Rate"}) %}
{% elif "msdrg_base_rate" in col or "msdrg_gc" in col or "op_gc" in col %}
{% set _ = imputation_method_mapping.update({col: "Inferred Base Rate"}) %}
{% elif "rc_family" in col %}
{% set _ = imputation_method_mapping.update({col: "Inferred RC Family Rate"}) %}
{% elif "rc_global" in col %}
{% set _ = imputation_method_mapping.update({col: "Inferred RC Global Rate"}) %}
{% elif "opg" in col %}
{% set _ = imputation_method_mapping.update({col: "Inferred Outpatient Procedure Grouper"}) %}
{% elif "cstm_" in col %}
{% set _ = imputation_method_mapping.update({col: "MRF-CSTM"}) %}
{% endif %}
{% endfor %}
{% set transformation_method_mapping = {} %}
{% for col in hospital_transformation_cols + payer_transformation_cols + imputation_cols %}
{% if "per_diem" in col %}
{% set _ = transformation_method_mapping.update({col: "Per Diem to Dollar"}) %}
{% elif "perc_to_dol" in col %}
{% set _ = transformation_method_mapping.update({col: "Percentage to Dollar"}) %}
{% endif %}
{% endfor %}
{% set gross_charge_type_mapping = {} %}
{% for col in hospital_transformation_cols + payer_transformation_cols + imputation_cols %}
{% if "_cbsa" in col %}
{% set _ = gross_charge_type_mapping.update({col: "CBSA Median"}) %}
{% elif "_state" in col %}
{% set _ = gross_charge_type_mapping.update({col: "State Median"}) %}
{% elif "gc_hosp" in col %}
{% set _ = gross_charge_type_mapping.update({col: "Hospital"}) %}
{% elif "gc_komodo" in col %}
{% set _ = gross_charge_type_mapping.update({col: "Hospital"}) %}
{% elif "drug_dosage_" in col %}
{% set _ = gross_charge_type_mapping.update({col: "Hospital"}) %}
{% endif %}
{% endfor %}
{% set gross_charge_source_mapping = {} %}
{% for col in hospital_transformation_cols + payer_transformation_cols + imputation_cols %}
{% if "gc_hosp" in col %}
{% set _ = gross_charge_source_mapping.update({col: "Hospital"}) %}
{% elif "gc_komodo" in col %}
{% set _ = gross_charge_source_mapping.update({col: "Claims"}) %}
{% elif "drug_dosage_" in col %}
{% set _ = gross_charge_source_mapping.update({col: "Hospital"}) %}
{% endif %}
{% endfor %}
{% macro rate_score_array(rate_cols) %}
ARRAY[
-1,
{% for c in (rate_cols) %}
a.{{ c }}_validation_score{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro rate_array(rate_cols) %}
ARRAY[
NULL,
{% for c in (rate_cols) %}
c.{{ c }}{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro source_array(rate_cols) %}
ARRAY[
NULL,
{% for c in (rate_cols) %}
'{{ source_mapping[c] }}'{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro rate_type_array(rate_cols) %}
ARRAY[
NULL,
{% for c in (rate_cols) %}
'{{ rate_type_mapping[c] }}'{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro methodology_array(rate_cols) %}
ARRAY[
NULL,
{% for c in (rate_cols) %}
{% if c in methodology_mapping %}
'{{ methodology_mapping[c] }}'
{% else %}
CASE
WHEN {{ 'payer_negotiated' in c or 'payer_derived' in c }} AND (c.bill_type = 'Professional')
THEN 'Fee Schedule'
WHEN {{ 'payer_negotiated' in c or 'payer_derived' in c }} AND (is_surg_code = True OR c.bill_type = 'Inpatient')
THEN 'Case Rate'
WHEN {{ 'payer_negotiated' in c or 'payer_derived' in c }} AND COALESCE(is_surg_code, False) = False
THEN 'Fee Schedule'
WHEN {{ 'per_diem' in c }} AND c.bill_type NOT IN ('Inpatient')
THEN 'Case Rate'
WHEN {{ 'per_diem' in c }} AND c.bill_type IN ('Inpatient')
THEN 'Per Diem'
ELSE 'Unknown'
END
{% endif %}
{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro rate_class_array(rate_cols) %}
ARRAY[
NULL,
{% for c in (rate_cols) %}
'{{ rate_class_mapping[c] }}'{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro imputation_method_array(rate_cols) %}
ARRAY[
NULL,
{% for c in (rate_cols) %}
{% if c in imputation_method_mapping %}
'{{ imputation_method_mapping[c] }}'
{% else %}
NULL
{% endif %}
{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro transformation_method_array(rate_cols) %}
ARRAY[
NULL,
{% for c in (rate_cols) %}
{% if c in transformation_method_mapping %}
'{{ transformation_method_mapping[c] }}'
{% else %}
NULL
{% endif %}
{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro gross_charge_type_array(rate_cols) %}
ARRAY[
NULL,
{% for c in (rate_cols) %}
{% if c in gross_charge_type_mapping %}
'{{ gross_charge_type_mapping[c] }}'
{% else %}
NULL
{% endif %}
{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro gross_charge_source_array(rate_cols) %}
ARRAY[
NULL,
{% for c in (rate_cols) %}
{% if c in gross_charge_source_mapping %}
'{{ gross_charge_source_mapping[c] }}'
{% else %}
NULL
{% endif %}
{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro rate_id_array(rate_cols_no_impute) %}
ARRAY[
NULL,
{% for c in (rate_cols_no_impute) %}
{% if c in non_transformed_column_maps %}
c.{{ non_transformed_column_maps[c] }}_id
{% else %}
c.{{ c.replace('_anesthesia_cf', '') }}_id
{% endif %}
{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro original_billing_codes_array(rate_cols) %}
ARRAY[
NULL,
{% for c in rate_cols %}
{% if c in original_billing_code_maps %}
{{ original_billing_code_maps[c] }}
{% else %}
NULL
{% endif %}
{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro original_billing_code_type_array(rate_cols) %}
ARRAY[
NULL,
{% for c in rate_cols %}
{% if c in original_billing_code_type_maps %}
{{ original_billing_code_type_maps[c] }}
{% else %}
NULL
{% endif %}
{% if not loop.last %}, {% endif %}
{% endfor %}
]
{% endmacro %}
{% macro gross_charge_hierarchy_fallback() %}
COALESCE(
{% for col in cld_params.GROSS_CHARGE_COLS %}
c.{{ col }}{% if not loop.last %},{% endif %}
{% endfor %}
)
{% endmacro %}
{% macro gross_charge_type_hierarchy_fallback() %}
CASE
{% for col in cld_params.GROSS_CHARGE_COLS %}
WHEN c.{{ col }} IS NOT NULL THEN
{% if col == 'mrf_gross_charge_provider' %}'mrf_gross_charge_provider'
{% elif col == 'komodo_gross_charge_provider' %}'komodo_gross_charge_provider'
{% elif col == 'mrf_gross_charge_state_median' %}'mrf_gross_charge_state_median'
{% elif col == 'komodo_gross_charge_cbsa_median' %}'komodo_gross_charge_cbsa_median'
{% elif col == 'komodo_gross_charge_state_median' %}'komodo_gross_charge_state_median'
{% elif col == 'mrf_gross_charge_cbsa_median' %}'mrf_gross_charge_cbsa_median'
{% endif %}
{% endfor %}
ELSE NULL
END
{% endmacro %}
{% macro gross_charge_source_hierarchy_fallback() %}
CASE
{% for col in cld_params.GROSS_CHARGE_COLS %}
WHEN c.{{ col }} IS NOT NULL THEN
{% if col == 'mrf_gross_charge_provider' %}'Hospital'
{% elif col == 'komodo_gross_charge_provider' %}'Claims'
{% elif col == 'mrf_gross_charge_state_median' %}'Hospital'
{% elif col == 'komodo_gross_charge_cbsa_median' %}'Claims'
{% elif col == 'komodo_gross_charge_state_median' %}'Claims'
{% elif col == 'mrf_gross_charge_cbsa_median' %}'Hospital'
{% endif %}
{% endfor %}
ELSE NULL
END
{% endmacro %}
{% macro payer_only_rate_score_array(rate_cols_no_impute) %}
ARRAY[
-1,
{%- for c in (rate_cols_no_impute) -%}
{%- if c.startswith("payer_") -%}
a.{{ c }}_validation_score
{%- else -%}
-1
{%- endif -%}
{%- if not loop.last -%}, {%- endif -%}
{%- endfor -%}
]
{% endmacro %}
{% macro payer_only_rate_type_array(rate_cols_no_impute) %}
ARRAY[
NULL,
{%- for c in (rate_cols_no_impute) -%}
{%- if c.startswith("payer_") -%}
'{{ rate_type_mapping[c] }}'
{%- else -%}
NULL
{%- endif -%}
{%- if not loop.last -%}, {%- endif -%}
{%- endfor -%}
]
{% endmacro %}
{% macro payer_only_rate_array(rate_cols_no_impute) %}
ARRAY[
NULL,
{%- for c in (rate_cols_no_impute) -%}
{%- if c.startswith("payer_") -%}
c.{{ c }}
{%- else -%}
NULL
{%- endif -%}
{%- if not loop.last -%}, {%- endif -%}
{%- endfor -%}
]
{% endmacro %}
{% macro hospital_only_rate_score_array(rate_cols_no_impute) %}
ARRAY[
-1,
{%- for c in (rate_cols_no_impute ) -%}
{%- if c.startswith("hosp") or c.startswith("drug") -%}
a.{{ c }}_validation_score
{%- else -%}
-1
{%- endif -%}
{%- if not loop.last -%}, {%- endif -%}
{%- endfor -%}
]
{% endmacro %}
{% macro hospital_only_rate_type_array(rate_cols_no_impute) %}
ARRAY[
NULL,
{%- for c in (rate_cols_no_impute) -%}
{%- if c.startswith("hosp") or c.startswith("drug") -%}
'{{ rate_type_mapping[c] }}'
{%- else -%}
NULL
{%- endif -%}
{%- if not loop.last -%}, {%- endif -%}
{%- endfor -%}
]
{% endmacro %}
{% macro hospital_only_rate_array(rate_cols_no_impute) %}
ARRAY[
NULL,
{%- for c in (rate_cols_no_impute) -%}
{%- if c.startswith("hosp") or c.startswith("drug") -%}
c.{{ c }}
{%- else -%}
NULL
{%- endif -%}
{%- if not loop.last -%}, {%- endif -%}
{%- endfor -%}
]
{% endmacro %}
CREATE OR REPLACE TABLE {{ schema_name }}.tmp_int_combined_no_whisp_{{ n_chunk }}_{{ sub_version }}
WITH (
PARTITIONING = ARRAY['payer_id']
)
AS
WITH
combined_with_rate_arrays AS (
SELECT
c.*,
{% for col in ip_rate_cols %}
a.{{ col }}_validation_score,
{% endfor %}
{% for col in outlier_bounds %}
a.{{ col }},
{% endfor %}
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ rate_score_array(ip_rate_cols) }} ELSE {{ rate_score_array(non_ip_rate_cols) }}
END AS rate_score_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ rate_score_array(ip_rate_cols_no_impute) }} ELSE {{ rate_score_array(non_ip_rate_cols_no_impute) }}
END AS rate_score_array_no_impute,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ rate_array(ip_rate_cols) }} ELSE {{ rate_array(non_ip_rate_cols) }}
END AS rate_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ source_array(ip_rate_cols) }} ELSE {{ source_array(non_ip_rate_cols) }}
END AS source_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ rate_type_array(ip_rate_cols) }} ELSE {{ rate_type_array(non_ip_rate_cols) }}
END AS rate_type_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ methodology_array(ip_rate_cols) }} ELSE {{ methodology_array(non_ip_rate_cols) }}
END AS methodology_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ rate_class_array(ip_rate_cols) }} ELSE {{ rate_class_array(non_ip_rate_cols) }}
END AS rate_class_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ imputation_method_array(ip_rate_cols) }} ELSE {{ imputation_method_array(non_ip_rate_cols) }}
END AS imputation_method_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ transformation_method_array(ip_rate_cols) }} ELSE {{ transformation_method_array(non_ip_rate_cols) }}
END AS transformation_method_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ gross_charge_type_array(ip_rate_cols) }} ELSE {{ gross_charge_type_array(non_ip_rate_cols) }}
END AS gross_charge_type_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ gross_charge_source_array(ip_rate_cols) }} ELSE {{ gross_charge_source_array(non_ip_rate_cols) }}
END AS gross_charge_source_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ rate_id_array(ip_rate_cols_no_impute) }} ELSE {{ rate_id_array(non_ip_rate_cols_no_impute) }}
END AS rate_id_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ original_billing_codes_array(ip_rate_cols) }} ELSE {{ original_billing_codes_array(non_ip_rate_cols) }}
END AS original_billing_codes_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ original_billing_code_type_array(ip_rate_cols) }} ELSE {{ original_billing_code_type_array(non_ip_rate_cols) }}
END AS original_billing_code_type_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ payer_only_rate_score_array(ip_rate_cols_no_impute) }} ELSE {{ payer_only_rate_score_array(non_ip_rate_cols_no_impute) }}
END AS payer_rate_score_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ payer_only_rate_type_array(ip_rate_cols_no_impute) }} ELSE {{ payer_only_rate_type_array(non_ip_rate_cols_no_impute) }}
END AS payer_rate_type_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ payer_only_rate_array(ip_rate_cols_no_impute) }} ELSE {{ payer_only_rate_array(non_ip_rate_cols_no_impute) }}
END AS payer_rate_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ hospital_only_rate_score_array(ip_rate_cols_no_impute) }} ELSE {{ hospital_only_rate_score_array(non_ip_rate_cols_no_impute) }}
END AS hospital_rate_score_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ hospital_only_rate_type_array(ip_rate_cols_no_impute) }} ELSE {{ hospital_only_rate_type_array(non_ip_rate_cols_no_impute) }}
END AS hospital_rate_type_array,
CASE WHEN c.bill_type = 'Inpatient'
THEN {{ hospital_only_rate_array(ip_rate_cols_no_impute) }} ELSE {{ hospital_only_rate_array(non_ip_rate_cols_no_impute) }}
END AS hospital_rate_array
FROM {{ schema_name }}.tmp_int_combined_brit_{{ sub_version }} c
LEFT JOIN {{ schema_name }}.tmp_int_accuracy_brit_{{ sub_version }} a
ON c.roid = a.roid
AND c.payer_id = a.payer_id
),
with_best_idx AS (
SELECT
c.*,
ARRAY_POSITION(rate_score_array, array_max(rate_score_array)) AS best_idx,
ARRAY_POSITION(rate_score_array_no_impute, array_max(rate_score_array_no_impute)) AS best_idx_no_impute,
ARRAY_POSITION(payer_rate_score_array, array_max(payer_rate_score_array)) AS best_payer_idx,
ARRAY_POSITION(hospital_rate_score_array, array_max(hospital_rate_score_array)) AS best_hospital_idx
FROM combined_with_rate_arrays c
)
SELECT
c.roid,
{%- for col in payer_spine_cols -%}
payer_spine.{{ col }},
{%- endfor -%}
c.network_id,
{%- for col in network_spine_cols -%}
network_spine.{{ col }},
{%- endfor -%}
payer_spine.payer_name || ' ' || network_spine.network_name as payer_network_name,
COALESCE(prov_spine.state, '') || ' ' ||
COALESCE(prov_spine.cbsa, '') || ' ' ||
COALESCE(prov_spine.provider_name, '') || ' ' ||
COALESCE(network_spine.network_name, '') || ' ' ||
COALESCE(payer_spine.payer_name, '') as generic_search,
c.provider_id,
{% for col in prov_spine_cols %}
prov_spine.{{ col }},
{% endfor %}
{% for col in code_spine_cols %}
code_spine.{{ col }},
{% endfor %}
c.bill_type,
c.billing_code,
c.billing_code_type,
c.facility,
{% for col in cash_charges %}
c.{{ col }},
{% endfor %}
{% for col in gross_charges %}
c.{{ col }},
{% endfor %}
{% for col in outlier_bounds %}
c.{{ col }},
{% endfor %}
{% for col in ip_rate_cols %}
c.{{ col }},
{% endfor %}
{% for col in ip_rate_cols %}
c.{{ col }}_validation_score,
{% endfor %}
{% for col in original_nontransformed_cols %}
c.{{ col }},
{% endfor %}
rate_array[
best_idx
] as canonical_rate,
rate_score_array[
best_idx
] as canonical_rate_validation_score,
CASE
{% for vscore, label in cld_params.VALIDATION_MAPPING.items() %}
WHEN FLOOR(array_max(rate_score_array)) = {{ vscore }} THEN '{{ label }}'
{% endfor %}
ELSE NULL
END as canonical_rate_validation_method,
CASE
{% for vscore, cscore in cld_params.CONFIDENCE_SCORES.items() %}
WHEN FLOOR(array_max(rate_score_array)) = {{ vscore }} THEN {{ cscore }}
{% endfor %}
ELSE 0
END as canonical_rate_score,
CASE WHEN is_nan(rate_array[best_idx] / c.medicare_rate) THEN NULL ELSE rate_array[best_idx] / c.medicare_rate END as canonical_rate_percent_of_medicare,
CASE WHEN is_nan(rate_array[best_idx] / c.cbsa_avg_medicare_rate) THEN NULL ELSE rate_array[best_idx] / c.cbsa_avg_medicare_rate END as canonical_rate_percent_of_cbsa_avg_medicare,
CASE WHEN is_nan(rate_array[best_idx] / c.state_avg_medicare_rate) THEN NULL ELSE rate_array[best_idx] / c.state_avg_medicare_rate END as canonical_rate_percent_of_state_avg_medicare,
CASE WHEN is_nan(rate_array[best_idx] / c.national_avg_medicare_rate) THEN NULL ELSE rate_array[best_idx] / c.national_avg_medicare_rate END as canonical_rate_percent_of_national_avg_medicare,
CASE WHEN is_nan(rate_array[best_idx] / c.asc_avg_medicare_rate) THEN NULL ELSE rate_array[best_idx] / c.asc_avg_medicare_rate END as canonical_rate_percent_of_asc_medicare,
CASE WHEN is_nan(rate_array[best_idx] / c.lab_avg_medicare_rate) THEN NULL ELSE rate_array[best_idx] / c.lab_avg_medicare_rate END as canonical_rate_percent_of_lab_medicare,
CASE WHEN is_nan(rate_array[best_idx] / c.mrf_gross_charge_provider) THEN NULL ELSE rate_array[best_idx] / c.mrf_gross_charge_provider END as canonical_rate_percent_of_list,
source_array[best_idx] as canonical_rate_source,
rate_type_array[best_idx] as canonical_rate_type,
methodology_array[best_idx] as canonical_contract_methodology,
rate_class_array[best_idx] as canonical_rate_class,
imputation_method_array[best_idx] as canonical_imputation_method,
transformation_method_array[best_idx] as canonical_transformation_method,
CASE
WHEN
original_billing_code_type_array[best_idx] IS NOT NULL
THEN
'Crosswalked From ' || original_billing_code_type_array[best_idx] || ' to ' || c.billing_code_type
END as canonical_crosswalk_method,
CASE
WHEN rate_type_array[best_idx] like '%gc_hosp_cbsa%'
THEN 'mrf_gross_charge_cbsa_median'
WHEN rate_type_array[best_idx] like '%gc_hosp_state%'
THEN 'mrf_gross_charge_state_median'
WHEN rate_type_array[best_idx] like '%gc_hosp%'
THEN 'mrf_gross_charge_provider'
WHEN rate_type_array[best_idx] like '%gc_komodo_cbsa%'
THEN 'komodo_gross_charge_cbsa_median'
WHEN rate_type_array[best_idx] like '%gc_komodo_state%'
THEN 'komodo_gross_charge_state_median'
WHEN rate_type_array[best_idx] like '%gc_komodo%'
THEN 'komodo_gross_charge_provider'
WHEN
rate_type_array[best_idx] like '%drug_dosage_%'
THEN 'mrf_gross_charge_provider'
ELSE {{ gross_charge_type_hierarchy_fallback() }}
END as canonical_gross_charge_type,
CASE
WHEN rate_type_array[best_idx] like '%gc_hosp_cbsa%'
THEN 'Hospital'
WHEN rate_type_array[best_idx] like '%gc_hosp_state%'
THEN 'Hospital'
WHEN rate_type_array[best_idx] like '%gc_hosp%'
THEN 'Hospital'
WHEN rate_type_array[best_idx] like '%gc_komodo_cbsa%'
THEN 'Claims'
WHEN rate_type_array[best_idx] like '%gc_komodo_state%'
THEN 'Claims'
WHEN rate_type_array[best_idx] like '%gc_komodo%'
THEN 'Claims'
WHEN
rate_type_array[best_idx] like '%drug_dosage_%'
THEN 'Hospital'
ELSE {{ gross_charge_source_hierarchy_fallback() }}
END as canonical_gross_charge_source,
rate_categories.canonical_rate_category,
CASE
{% for k,v in traceability_params.items() %}
WHEN rate_type_array[
best_idx
] LIKE '%{{ k }}%'
{% if v %}THEN {{ v }}{% else %}THEN NULL{% endif %}
{% endfor %}
END as canonical_method_params,
CASE
WHEN rate_type_array[best_idx] like '%gc_hosp_cbsa%'
THEN mrf_gross_charge_cbsa_median * gross_charge_cbsa_provider_adjustment
WHEN rate_type_array[best_idx] like '%gc_hosp_state%'
THEN mrf_gross_charge_state_median * gross_charge_state_provider_adjustment
WHEN rate_type_array[best_idx] like '%gc_hosp%'
THEN mrf_gross_charge_provider
WHEN rate_type_array[best_idx] like '%gc_komodo_cbsa%'
THEN komodo_gross_charge_cbsa_median * gross_charge_cbsa_provider_adjustment
WHEN rate_type_array[best_idx] like '%gc_komodo_state%'
THEN komodo_gross_charge_state_median * gross_charge_state_provider_adjustment
WHEN rate_type_array[best_idx] like '%gc_komodo%'
THEN komodo_gross_charge_provider
WHEN rate_type_array[best_idx] like '%drug_dosage_%'
THEN mrf_gross_charge_provider
ELSE {{ gross_charge_hierarchy_fallback() }}
END as canonical_gross_charge,
CASE
WHEN rate_type_array[best_idx] like '%gc_hosp%'
THEN mrf_gross_charge_provider_original_billing_code
ELSE NULL
END as canonical_rate_gross_charge_original_billing_codes,
CASE
WHEN rate_type_array[best_idx] like '%gc_hosp%'
THEN mrf_gross_charge_provider_original_billing_code_type
ELSE NULL
END as canonical_rate_gross_charge_original_billing_code_type,
rate_id_array[best_idx_no_impute] as canonical_rate_id,
original_billing_codes_array[best_idx] as canonical_rate_original_billing_codes,
original_billing_code_type_array[best_idx] as canonical_rate_original_billing_code_type,
payer_rate_array[best_payer_idx] as best_payer_rate,
payer_rate_type_array[best_payer_idx] as best_payer_rate_type,
payer_rate_score_array[best_payer_idx] as best_payer_rate_validation_score,
CASE
{% for vscore, cscore in cld_params.CONFIDENCE_SCORES.items() %}
WHEN FLOOR(array_max(payer_rate_score_array)) = {{ vscore }} THEN {{ cscore }}
{% endfor %}
ELSE 0
END as best_payer_rate_score,
hospital_rate_array[best_hospital_idx] as best_hospital_rate,
hospital_rate_type_array[best_hospital_idx] as best_hospital_rate_type,
hospital_rate_score_array[best_hospital_idx] as best_hospital_rate_validation_score,
CASE
{% for vscore, cscore in cld_params.CONFIDENCE_SCORES.items() %}
WHEN FLOOR(array_max(hospital_rate_score_array)) = {{ vscore }} THEN {{ cscore }}
{% endfor %}
ELSE 0
END as best_hospital_rate_score,
{% for col in allowed_amount_stats %}
c.{{ col }},
{% endfor %}
{% for col in imputation_stats %}
c.{{ col }},
{% endfor %}
{% for col in benchmark_cols %}
c.{{ col }},
{% endfor %}
{% for col in transformation_utils %}
c.{{ col }},
{% endfor %}
c.payer_id
FROM with_best_idx c
LEFT JOIN {{ schema_name }}.tmp_ref_provider_spine_{{ sub_version }} prov_spine
ON c.provider_id = prov_spine.provider_id
LEFT JOIN {{ schema_name }}.tmp_ref_payer_spine_{{ sub_version }} payer_spine
ON c.payer_id = payer_spine.payer_id
LEFT JOIN {{ schema_name }}.tmp_ref_network_spine_{{ sub_version }} network_spine
ON c.network_id = network_spine.network_id
LEFT JOIN {{ schema_name }}.tmp_ref_code_spine_{{ sub_version }} code_spine
ON c.bill_type = code_spine.bill_type
AND c.billing_code = code_spine.billing_code
AND c.billing_code_type = code_spine.billing_code_type
AND (
c.facility = code_spine.facility
OR (c.facility IS NULL AND code_spine.facility IS NULL)
)
LEFT JOIN {{ cld_params.Tables.RATE_TYPE_CATEGORIES.value }} rate_categories
ON rate_type_array[
ARRAY_POSITION(rate_score_array, array_max(rate_score_array))
] = rate_categories.canonical_rate_type
WHERE (
{% for item in payer_network_list %}
(c.payer_id = '{{ item.payer_id }}'
{% if item.payer_id == '643' and item.network_type %}
AND network_spine.network_type = '{{ item.network_type }}'
{% endif %}
)
{% if not loop.last %} OR {% endif %}
{% endfor %}
)