Note: 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 group.
- State is listed in group 3 (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.
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with t as ( select 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 ) 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 det ) select c.*, round( (c.medicaid_num / c.total_enc)*100,1) as medicaid_pct from ( select a.*, b.non_medicaid_num, a.Medicaid_num + b.non_medicaid_num as total_enc from ( select 'Practice Totals' as r, t.encounters as Medicaid_num from t where det = 'Medicaid') a left outer join (select 'Practice Totals' as r, t.encounters as non_Medicaid_num from t where det = 'not Medicaid') b on a.r = b.r ) c