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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

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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