Make Cost_types standard again

[clairblacketer]

The concept_ids 5031, 5032, 5033 have been moved to non-standard but I think they should be switched back to standard. There are 6 Cost Type concepts but the three that are standard do not adequately represent all cost types exist. They are:

1. Payer is primary (coordination of benefit)
2. Payer is secondary (coordination of benefit)
3. Premium

These do not cover costs that are billed by providers or paid by patients, they only cover costs that are outgoing from the payer or are considered premiums.

[cgreich]

Do you remember why we killed them in January?

[gowthamrao]

Concept_id	Concept_name
5031	Cost incurred by the provider
5032	Amount paid by the patient or reimbursed by the payer
5033	Amount charged to the patient or the payer by the provider, list price

These were originally 'Type concept' for cost, and we needed to clean them up. The new CDM 6+ cost tables has both cost_concept_id and cost_type_concept_id - and I think we need more specific type concepts to help with the provenance of the cost data. Currently they mostly support payer claims data based provenance, does not support EHR/billing system - for billed by providers etc. Reinstating these Type concepts as standard may be a good stop gap.

[cgreich]

Wait, @gowthamrao. They are still Cost Types today. Are you saying we need all 6 as concepts of the Cost domain?

[gowthamrao]

I think what @clairblacketer is saying is that we need appropriate Type Concepts for use in the field cost.cost_type_concept_id of the CDM 6.+ cost table that represents provenance such as

• derived from a payers administrative claims data
• derived from electronic health record billing system
• self reported by the person/patient

Currently we only have three type concepts that are appropriate for administrative claims data. We dont have type-concepts that are appropriate for self reported or EHR billing system provenance.

Concept Id	Code	Name	Class	Domain	Vocabulary
31970	OMOP generated	Premium	Type Concept	Type Concept	Cost Type
31968	OMOP generated	Payer is primary (coordination of benefit)	Type Concept	Type Concept	Cost Type
31969	OMOP generated	Payer is secondary (coordination of benefit)	Type Concept	Type Concept	Cost Type

[clairblacketer]

Based on the original proposal #81 the cost type concepts needed are:

• Copayment amount
• Coinsurance amount
• Charged by the provider
• Recovered by the provider
• Allowed by the primary payer
• Paid by the primary payer
• Allowed by the secondary payer
• Paid by the secondary payer
• Allowed by all payers
• Paid by all payers
• Charged to the patient
• Paid by the patient total out of pocket
• Paid by the patient towards co-insurance
• Paid by the patient towards copay
• Paid by the patient towards deductible
• Fee for pharmacy dispensing
• Cost of pharmacy ingredient
• Average Wholesale Price amount

[gowthamrao]

@clairblacketer

I am little confused here, especially because we seem to be mixing up cost_type_concept_id and cost_concept_id

We have good cost_concept_id's (Domain = Cost, Vocabulary = omop cost)

• Concepts for Summary costs
• Concepts for Detail costs

What we are missing are good concepts to populate cost_type_concept_id (domain = Type Concept, Class = Cost Type)

• The closest we have are domain = Type Concept, Class = Type concept here . We need to add more here.

Concept Id	Code	Name	Class	Domain	Vocabulary
31970	OMOP generated	Premium	Cost Type	Type Concept	Cost Type
31968	OMOP generated	Payer is primary (coordination of benefit)	Cost Type	Type Concept	Cost Type
31969	OMOP generated	Payer is secondary (coordination of benefit)	Cost Type	Type Concept	Cost Type
	OMOP generated	Billing system (Electronic Health Record)	Cost Type	Type Concept	Cost Type
	OMOP generated	Bills (Reported by person)	Cost Type	Type Concept	Cost Type
	OMOP generated	Payments (Reported by person)	Cost Type	Type Concept	Cost Type

[clairblacketer]

@gowthamrao you're right, I was looking at an older forum conversation when I commented above

[ericaVoss]

@gowthamrao & @cgreich & @aostropolets & @dimshitc ,

Are these slated to be added to the Vocab any time soon - we are going to V6 soon and like to have these ready for when we work on that

[dimshitc]

So what do we need, to add these 3 concepts:
Billing system (Electronic Health Record)
Bills (Reported by person)
Payments (Reported by person),
nothing else, right?

[dimshitc]

done