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Version: 3.0

Rate Type Categories

Every rate in Clear Rates output belongs to one of four categories reflecting data defensibility.

Four Categories

CategorySourceDescriptionTypical canonical_rate_type prefix
Posted RatesPayer MRF, Hospital MRFFixed dollar amounts from MRF files. No estimation. Most defensible.raw: payer_*, raw: hospital_*_dollar, impute: msdrg_mrf_base_rate_*
Real-World RatesPayer MRF, Hospital MRF, KomodoVariable-rate provisions where all components come from reported data (e.g. 90% of charges × hospital's own reported charge).raw: hospital_*_allowed_amount, transform: hosp_per_diem_mult_glos, transform: *_gc_hosp_perc_to_dol
Enhanced RatesMRF provision + estimated benchmarkMRF reports one component but not the charge. Turquoise fills in the missing component from Komodo or geographic averages.transform: *_gc_komodo_perc_to_dol, *_gc_hosp_cbsa_perc_to_dol, most impute:*
Benchmark RatesMedicare referenceEntirely derived from reference data — no reliable MRF data available. Last resort.benchmark_* columns

Tie-Breaking Priority

When multiple rates share the same integer accuracy score, the category hierarchy determines which wins:

PriorityCategoryRationale
1Posted RatesAll components from reported data, no estimation
2Real-World RatesAll components from reported data, but rate varies by claim
3Enhanced RatesProvision reported, but one component estimated from benchmarks
4Benchmark RatesEntirely benchmark-derived — most speculative

Where Rate Types Appear

canonical_rate_type records the exact column name with a category prefix (e.g., "raw: payer_negotiated_rate", "transform: hospital_perc_gc_hosp_perc_to_dol", "impute: rc_family_gc_hosp_perc_to_dol"). Users can filter by prefix to understand what fraction of coverage comes from each data quality tier.

Sub-version merging

When the orchestrator merges multiple months, a validated rate (score 7) from an older sub-version beats an unvalidated rate (score 6) from a newer one. Same-score ties across sub-versions use the rate type hierarchy: Posted beats Real-World beats Enhanced beats Benchmark.