We are currently updating the OP Help Center content for the release of OP 19, which is a member of the certified OP 14 family of products. OP 19’s official version is 14.19.1, which you may see in your software (such as in Help > About) and in the Help Center tabs labeled 14.19. You may also notice that the version number in content and videos may not match the version of your software, and some procedural content may not match the workflow in your software. We appreciate your patience and understanding as we make these enhancements.

SQL: Zero-Paid Claims Per Month

About

This report looks at the number of claims per calendar month (for a date range you specify) that were completely written off  on the insurance-side. This is a good general monitor for performance around timely filing and appeals for your billing department.

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

Caveats

This SQL looks only for adjudicated claims where the total adjustment amount is equal to the total charge amount.  The total charge amount must be at least $0.01.

Code

To highlight and copy the code below to your clipboard, simply click the Copy button.

select case when c is null then 0 else c end as ttl_claims,  date_axis from
(
select count(claim_note) as c, mo, yr from
(

select extract(month from claimdate) as mo, extract(year from claimdate) as yr, claimdate, claim_note from
(

select claimdate, claim_note, invoiceno, charge, payment, adjustment  from claims1 where charge=adjustment and claimdate between :start_date and :end_date and charge >= 0.01
order by claimdate

)
) a
group by a.yr, a.mo
) b

right outer join
(
select ( yr || ' / ' || mo) as date_axis, mo, yr from
(

select distinct extract(month from date1) as mo, extract(year from date1) as yr from archive_transactions where date1 between :start_date and :end_date
order by yr, mo
)
) t on t.yr=b.yr and t.mo=b.mo