About
This report identifies unique Medicaid encounters (patient and date of service) for Medicaid, for 90 days beginning on a reference date you specify. It is meant to be used to make sure you have properly labeled all the different Medicaid insurance plans in your practice as “Medicaid” before you attempt to compute a percent Medicaid for Meaningful Use.
A sample image of this SQL report run in the Database Viewer is shown below:
Caveats
- The insurance plan must be listed as a Medicaid in the OP insurance tables. Path: Utilities > Manage Practice > Insurance Payers > Edit > Claims/Routing > Claim type: Medicaid.
- Because this report is not intended to be used directly for Meaningful Use submission, all locations and all providers in the practice are grouped together.
- Only encounters where a claim was submitted to the Medicaid plan are counted - even if the claim was denied.
- Primary, secondary, and tertiary Medicaid plans are counted.
Code
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select ins_carrier.ins_carrier_code, ins_carrier_name, encounters from ins_carrier
left outer join
(
select count(uniqid) as encounters, ins_carrier_code from
(
select distinct uniqid, ins_carrier_code from (
select patno, date1, (patno || ' ' || date1) as uniqid, cptcode, ins_carrier_code from archive_transactions at1
where at1.cptcode not in ('1','2','3','4') and pos not in (21,23) and
at1.date1 between :attestation_start and ( :attestation_start + 89) and at1.archive_flag = 1
union
select patno, date1, (patno || ' ' || date1) as uniqid, cptcode, ins_carrier_code_other as ins_carrier_code from archive_transactions at2
where at2.cptcode not in ('1','2','3','4') and pos not in (21,23) and
at2.date1 between :attestation_start and ( :attestation_start + 89) and at2.archive_flag = 1
) ata1
)
group by ins_carrier_code ) ata2
on ata2.ins_carrier_code = ins_carrier.ins_carrier_code
where claim_filing_code = 'MC' and ins_carrier.archive_flag in (0,2)
