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SQL: Basic A/R for Open Claims for Dates

About

This report shows all open claims (either insurance-side or patient-side) with a date of service between the dates you specify.  It also assigns an aging bucket of <30, 31-60, 61-90, 91-120, and 121+.

A sample image of this SQL report run in the Database Viewer is shown below:

Caveats

  • Any claim with a nonzero insurance balance OR a nonzero patient balance is shown.
  • ALL_AGING is the computed days of aging.  
  • For insurance-side balances, ALL_AGING is the difference between the date of service and the run date.  This report does not re-start aging with re-assignment to secondary insurances.
  • For patient_side balances, ALL_AGING is the difference between the patient responsibility date and the run date.
  • Only archived transactions and non-voided transactions are shown.

Code

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select trnsxno, rend_staff, patno, dos, ins_carrier_code, cptcode, charge, ins_balance, pt_balance, p1 as ins_paid, a1 as ins_adj, c1 as pt_paid, w1 as pt_adj, all_aging, case when all_aging <=30 then '0-30' when all_aging >30 and all_aging <=60 then '31-60' when all_aging >60 and all_aging <=90 then '61-90' when all_aging >90 and all_aging <=120 then '91-120' else '121+'  end as aging from
(
select b.*, case when ins_balance >= 0.01 then cast('today' as date)-dos  when pt_balance >=0.01 then cast('today' as date)- coalesce(pt_resp_date,dos) end as all_aging from
(
select a.* from
(
select trnsxno,staffname as rend_staff, patno,  date1 as DOS, ins_carrier_code, cptcode,  charge, tx_balance as ins_balance, copaybalance as pt_balance, coalesce(p,0) as  p1, coalesce(a,0) as a1, coalesce( c,0) as c1,coalesce(w,0) as w1 from
(select 
 trnsxno, patno, rend_addr_id, cptcode, date1, ins_carrier_code, charge, tx_balance, copaybalance from archive_transactions where date1 between :startdate and :enddate and cptcode not in ('1','2','3','4') and archive_flag = 1) at1
left outer join
(select txnopaid,  sum(payment) as p,  sum(adjustment) as a, sum(copayrecd) as c, sum(copayadjustment) as w from archive_transactions where archive_flag = 1 group by txnopaid) at2 on at2.txnopaid = at1.trnsxno
left outer join
staff1 on staff1.staffid = at1.rend_addr_id
) a
where abs(charge - p1-a1-c1-w1 )>=0.01 and (ins_balance >= 0.01 or pt_balance >=0.01)
) b 
left outer join 
(select txnopaid, max(date1) as pt_resp_date from archive_transactions where cptcode ='4' and archive_flag = 1 group by txnopaid) at3 on b.trnsxno = at3.txnopaid
) c