Configuring the Geneva Transformer

The Geneva data transformer computes the primarycaresetting, primarycaresettingreason, and secondarycaresettings columns in the claim, encounter, condition, and procedure tables.

For claims, the caresetting will be computed by inspecting combinations of the claim’s type, subtype, facility type and the procedures/services that are associated with the claim. For encounters, the caresetting will be computed by inspecting combinations of the patient class, admit source and the procedures/services that are associated with the encounter.

The Geneva data transformer is configured using the following Galileo parameters which encode caresetting definitions.

Please note:

• Source Data should conform to the Data Driver Checklist.
• Criteria within each definition are ANDed together.
• Specify OR logic by creating two definitions with the same caresetting.
• The primarycaresetting will be determined by selecting the caresetting with the lowest assigned priority value.

Each definition must have:

• caresetting: (STRING) the caresetting code that will be applied.
• priority: (INTEGER) used to determine a primarycaresetting (lower priority values take precedence).

Geneva.PrimaryCareSetting.Claim

Each claim caresetting definition may have:

• isanchor: BOOLEAN. If True, claim will be used to construct derivedencounters.
• typecodes: (LIST of STRING)
• typevaluesets: (LIST of STRING)
• subtypecodes: (LIST of STRING)
• subtypevaluesets: (LIST of STRING)
• facilitytypecodes: (LIST of STRING)
• facilitytypevaluesets: (LIST of STRING)
• procedurecodevaluesets: (LIST of STRING)
• procedurerevenuecodes: (LIST of STRING)
• procedurerevenuevaluesets: (LIST of STRING)
• procedurelocationcodes: (LIST of STRING)
• procedurelocationvaluesets: (LIST of STRING)

For example:

[
  {
    'caresetting': 'IMP',
    'priority': 11,
    'subtypecodes': ['111', '117'],
    'isanchor': True
  },
  {
    'caresetting': 'IMP',
    'priority': 12,
    'procedurecodevaluesets': ['Inpatient']
  },
  {
    'caresetting': 'IMP',
    'priority': 13,
    'facilitytypecodes': ['21']
  },
  {
    'caresetting': 'EMER',
    'priority': 31,
    'subtypecodes': ['131', '137'],
    'isanchor': True
  },
  {
    'caresetting': 'EMER',
    'priority': 32,
    'procedurecodevaluesets': ['EDVisitProcedures']
  },
  {
    'caresetting': 'EMER',
    'priority': 33,
    'facilitytypecodes': ['23']
  },
  {
    'caresetting': 'EMER',
    'priority': 34,
    'procedurelocationcodes': ['23']
  },
  {
    'caresetting': 'NONAC-SNF',
    'priority': 41,
    'facilitytypecodes': ['31']
  },
  {
    'caresetting': 'NONAC-SNF',
    'priority': 42,
    'procedurelocationcodes': ['31']
  },
  {
    'caresetting': 'AMB-ASC',
    'priority': 51,
    'facilitytypecodes': ['43']
  },
  {
    'caresetting': 'AMB-ASC',
    'priority': 52,
    'procedurelocationcodes': ['43']
  },
  {
    'caresetting': 'AMB-UR',
    'priority': 61,
    'facilitytypecodes': ['20']
  },
  {
    'caresetting': 'AMB-UR',
    'priority': 62,
    'procedurelocationcodes': ['20']
  },
  {
    'caresetting': 'AMB-HOPD',
    'priority': 71,
    'facilitytypecodes': ['19', '22']
  },
  {
    'caresetting': 'AMB-HOPD',
    'priority': 72,
    'procedurelocationcodes': ['19', '22']
  },
]

Geneva.PrimaryCareSetting.Encounter

Each encounter caresetting definition may have:

• classcodes: (LIST of STRING)
• classvaluesets: (LIST of STRING)
• admitsourcecodes: (LIST of STRING)
• admitsourcevaluesets: (LIST of STRING)
• procedurecodevaluesets: (LIST of STRING)

For example:

[
  {
    'caresetting': 'IMP',
    'priority': 11,
    'classcodes': ['I', 'inpatient', 'Inpatient', 'IP'],
  },
  {
    'caresetting': 'EMER',
    'priority': 31,
    'classcodes': ['E', 'emergency'],
  },
  {
    'caresetting': 'EMER',
    'priority': 32,
    'admitsourcecodes': ['E', 'ER', 'EM', 'UR', 'Emergency'],
  },
]