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Version: 3.0

Stage 1b: Expanding Scope

How to add payers, networks, billing codes, and providers to a Clear Rates run. Scope is defined by the spine inputs — add an entity here and it flows through the entire pipeline.

How Scope Changes Propagate

1
Identify what to add
Payer? Network? New billing codes? New provider type? Each entity type has different files to edit.
2
Edit spine inputs
The right files depend on entity type: payer.sql for payers, network_mappings.py + variables_XXX.sql for networks, cld-utils SQL for codes, spines team for providers.
3
Re-run cld-utils (if codes)
Codeset tables are built by the cld-utils DAG, separate from the sub-DAG. Rebuild the codeset and update the params.py pointer.
tq_intermediate.cld_utils.*
4
Run Clear Rates sub-DAG
New entities flow through the full pipeline: spines → ROS → raw data → transformations → imputations → accuracy → rate selection.
prod_combined_abridged
note

Networks require the most coordination. A network is defined in network_mappings.py (single source of truth) and in ppo_payer_keywords in variables_XXX.sql for hospital MRF matching. If keywords don't match the normalized plan_name, hospital rates silently fail to map — no error is raised.

Quick Reference

EntityPrimary file(s)Additional file(s)Re-run cld-utils?
Payerpayer.sqlnetwork_mappings.py, variables_XXX.sqlNo
Networknetwork_mappings.pyvariables_XXX.sqlNo
Billing codescld-utils SQLparams.py (pointer update)Yes
Provider typecode.sql, rate_object_space.sqlplausibility tables, accuracy rulesNo

See the sub-pages for step-by-step instructions for each entity type.