SQL: MU Excluding Certain Payers from Attestation Volume Results

About

In rare circumstances, you may be billing two different Medicaid payers on a single date of service. For example, you might provide a checkup and bill the medical Medicaid MCO and on the same day provide fluoride varnish (which must be billed to a separate dental Medicaid MCO). The OP software will consider this two encounters, while for meaningful use purposes this must be counted as one single encounter. To exclude the dental MCO, you may list it here.

It is rare to bill more one Medicaid payer for the same patient on the same date of service, so most practices will not need to change anything.  However, if you have a significant number of encounters where this is the case (to the degree which it might affect your Meaningful Use participation), please contact Support. To exclude payers from the SQL report results:

  1. Select the SQL code you previously copied to the database viewer to obtain attestation results volume (state group and drill down codes). The selected code will appear in the edit box. You can edit the code from there.
  2. Search the code to locate this line:  and at1.ins_carrier_code not in ('XCLUD').
  3. Replace 'XCLUD' with your insurance payer code. Separate the insurance payer codes with single quotes, separated by commas, and no spacesFor example: change ('XCLUD') to ('THISPAYER','THATPAYER')
  4. Save the Code by clicking the Save SQL query text button.
  5. Run the code.

Caveats

This code should be added to both the state group and drill down codes you added to your database viewer. If you did not add the codes to your database viewer yet, please do so before attempting to change the code.