Note: Export, save, and print all results for audit purposes at the time you run them for actual volume validation.
Export, save, and print all results for audit purposes at the time you run them for actual volume validation.
A sample image of this SQL report run in the Database Viewer is shown below:
- Provider decision to submit results as an individual.
- State is listed in group 1 (see MU: State Group SQL Table and MU: State Assumptions).
- Depending on your billing, you may need to make some adjustments to the SQL code to exclude certain CPT codes from Encounter visits and/or to exclude some insurance payers as Medicaid.
To highlight and copy the code below to your clipboard, simply click the Copy button.
with t as ( select staffname, count(uniqid) as encounters, det from ( select distinct uniqid, staff1.staffname, a.ins_carrier_code, a.ins_carrier_code_other, i1.claim_filing_code as c1, i2.claim_filing_code as c2, case when (i1.claim_filing_code = 'MC' or i2.claim_filing_code = 'MC') then 'Medicaid' else 'not Medicaid' end as det from ( select patno, rend_addr_id, date1, (patno || ' ' || date1) as uniqid, cptcode, at1.ins_carrier_code, at1.ins_carrier_code_other from archive_transactions at1 where at1.cptcode not in ('1','2','3','4') and pos not in (21,23) and at1.cptcode not in ('113','99999','P1001') and at1.ins_carrier_code not in ('XCLUDE') and at1.date1 between :attestation_start and ( :attestation_start + 89) and at1.archive_flag = 1 and patno >99 ) a left outer join ins_carrier i1 on i1.ins_carrier_code = a.ins_carrier_code left outer join ins_carrier i2 on i2.ins_carrier_code = a.ins_carrier_code_other left outer join staff1 on staff1.staffid = a.rend_addr_id ) group by staffname, det order by staffname) select distinct staffname, med_enc, non_med_enc, round(((med_enc / (non_med_enc + med_enc))*100),1) as medicaid_pct from t left outer join (select encounters as Med_enc, staffname from t where det = 'Medicaid') m on m.staffname = t.staffname left outer join (select encounters as non_med_enc, staffname from t where det = 'not Medicaid') n on n.staffname = t.staffname where staffname <> ''