asked on
SET NOCOUNT ON
DECLARE
@groupby1 varchar(200),
@groupby2 varchar(200)
SET @groupby1 = convert(varchar(200),'None')
SET @groupby2 = convert(varchar(200),'None')
CREATE TABLE #Summary
(
PatientVisitID INT,
[Date of Entry] DATETIME,
Name VARCHAR(100),
Guarantor VARCHAR(100),
GuarantorId INT,
[Adjustment Type] VARCHAR(75),
TicketNumber VARCHAR(25),
[Procedure Code] VARCHAR(10),
[Adjustment Amount] money,
DateofServiceFrom DATETIME,
Notes VARCHAR(255),
[Financial Class] VARCHAR(200),
[Insurance Carrier] VARCHAR(60),
InsuredID VARCHAR(25),
[Policy Type] VARCHAR(200),
Facility VARCHAR(60),
Group1 VARCHAR(200),
Group2 VARCHAR(200),
MedicaidID VARCHAR(25),
NoRecord VARCHAR(1)
)
INSERT INTO #Summary
SELECT
pv.PatientVisitID,
b.Entry AS [Date Of Entry],
pp.[Last] + ', ' + pp.[First] AS Name,
dbo.FormatName(g.Prefix , g.First , g.Middle , g.Last , g.Suffix) AS Guarantor,
ISNULL(g.GuarantorID , 0) AS GuarantorId,
MedLists.Description AS [Adjustment Type],
pv.TicketNumber,
pvp.Code AS [Procedure Code],
td.Amount AS [Adjustment Amount],
pvp.DateOfServiceFrom,
ISNULL(CONVERT(VARCHAR(255), t.Note), ' ') AS Notes,
ISNULL(fc.Description, 'No Financial Class') AS [Financial Class],
ISNULL(ic.ListName,'No Insurance') AS [Insurance Carrier],
ISNULL(pi.InsuredId , '') AS InsuredID,
ISNULL(ml.Description,'No Insurance') AS [Policy Type],
dff.ListName as Facility,
CASE @groupby1
WHEN 'Facility' THEN dff.ListName
WHEN 'Financial Class' THEN ISNULL(fc.Description, 'No Financial Class')
WHEN 'Insurance Carrier' THEN ISNULL(ic.ListName,'No Insurance')
WHEN 'Policy Type' THEN ISNULL(ml.Description,'No Insurance')
ELSE 'None'
END as Group1,
CASE @groupby2
WHEN 'Facility' THEN dff.ListName
WHEN 'Financial Class' THEN ISNULL(fc.Description, 'No Financial Class')
WHEN 'Insurance Carrier' THEN ISNULL(ic.ListName,'No Insurance')
WHEN 'Policy Type' THEN ISNULL(ml.Description,'No Insurance')
ELSE 'None'
END as Group2,
medicareInsurance.InsuredId AS MedicaidId,
ISNULL(medicareInsurance.NoRecord,'') AS NoRecord
FROM
PaymentMethod pm
INNER JOIN VisitTransactions vt ON pm.PaymentMethodId = vt.PaymentMethodId
INNER JOIN Transactions t ON vt.VisitTransactionsId = t.VisitTransactionsId
INNER JOIN TransactionDistributions td ON t.TransactionsId = td.TransactionsId
INNER JOIN Batch b ON pm.BatchId = b.BatchId
INNER JOIN PatientVisit pv ON vt.PatientVisitid = pv.PatientVisitId
INNER JOIN PatientProfile pp ON pv.PatientProfileId = pp.PatientProfileId
LEFT OUTER JOIN MedLists ON t.ActionTypeMId = MedLists.MedListsId
LEFT OUTER JOIN PatientVisitProcs pvp ON td.PatientVisitProcsId = pvp.PatientVisitProcsId
LEFT OUTER JOIN InsuranceCarriers ic ON pv.PrimaryInsuranceCarriersID = ic.InsuranceCarriersID
LEFT JOIN PatientInsurance pi ON pv.PrimaryPICarrierId = pi.PatientInsuranceId
LEFT OUTER JOIN MedLists fc ON pv.FinancialClassMID = fc.MedListsID
LEFT OUTER JOIN MedLists ml ON ic.PolicyTypeMID = ml.MedListsID
INNER JOIN DoctorFacility dff ON pv.FacilityId = dff.DoctorFacilityId
LEFT OUTER JOIN Guarantor g ON pp.GuarantorID = g.GuarantorID
LEFT OUTER JOIN
(SELECT medicarepvi.patientvisitid,medicarepi.InsuredID, NoRecord='X' FROM PatientVisitInsurance medicarepvi INNER JOIN patientinsurance medicarepi ON medicarepvi.PatientInsuranceID = medicarepi.PatientInsuranceID
WHERE medicarepi.InsuranceCarriersId IN (4,3,7,2)) medicareInsurance ON medicareInsurance.patientvisitid = pv.patientvisitid
WHERE
t.Type = 'A'
AND --Filter on Source of Adjustment
(
('3' = pm.Source) OR
('3' = '3')
)
AND --Filter on Carrier
(
(NULL IS NOT NULL AND pv.PrimaryInsuranceCarriersID IN (NULL)) OR
(NULL IS NULL)
)
AND --Filter on adjustment type
(
(2 = 2 AND t.ActionTypeMId IN (3444)) OR
(2 = 1)
)
AND --Filter on doctor
(
(NULL IS NOT NULL AND pv.DoctorID IN (NULL)) OR
(NULL IS NULL)
)
AND --Filter on facility
(
(NULL IS NOT NULL AND pv.FacilityID IN (NULL)) OR
(NULL IS NULL)
)
AND --Filter on company
(
(NULL IS NOT NULL AND pv.CompanyID IN (NULL)) OR
(NULL IS NULL)
)
AND --Filter on date range
(
(1 = 1 AND b.Entry >= ISNULL('01/01/2010', '1/1/1900') AND b.Entry < DATEADD(d,1,ISNULL('12/31/2010','1/1/3000'))) OR
(1 <> 1 AND pm.DepositDate >= ISNULL('01/01/2010', '1/1/1900') AND pm.DepositDate < DATEADD(d,1,ISNULL('12/31/2010','1/1/3000')))
)
AND --Filter on date range
(
(pvp.DateofServiceFrom >= ISNULL(NULL, '1/1/1900') AND pvp.DateofServiceFrom < DATEADD(d,1,ISNULL(NULL,'1/1/3000')))
)
AND --Filter on procedures
(
(NULL IS NOT NULL AND pvp.ProceduresId IN (NULL)) OR
(NULL IS NULL)
)
ORDER BY
pp.[Last] + ', ' + pp.[First],
pvp.DateOfServiceFrom
IF 2 = 1 AND NULL IS NOT NULL
INSERT INTO #Summary
SELECT
pv.PatientVisitID,
b.Entry AS [Date Of Entry],
pp.[Last] + ', ' + pp.[First] AS Name,
dbo.FormatName(g.Prefix , g.First , g.Middle , g.Last , g.Suffix) AS Guarantor,
ISNULL(g.GuarantorID , 0) AS GuarantorId,
'FQHC Reimbursement' AS [Adjustment Type],
pv.TicketNumber,
pvp.Code AS [Procedure Code],
-1 * pvp.TotalFee AS [Adjustment Amount],
pvp.DateOfServiceFrom,
' ' AS Notes,
ISNULL(fc.Description, 'No Financial Class') AS [Financial Class],
ISNULL(ic.ListName,'No Insurance') AS [Insurance Carrier],
ISNULL(pi.InsuredId , '') AS InsuredID,
ISNULL(ml.Description,'No Insurance') AS [Policy Type],
dff.ListName as Facility,
CASE @groupby1
WHEN 'Facility' THEN dff.ListName
WHEN 'Financial Class' THEN ISNULL(fc.Description, 'No Financial Class')
WHEN 'Insurance Carrier' THEN ISNULL(ic.ListName,'No Insurance')
WHEN 'Policy Type' THEN ISNULL(ml.Description,'No Insurance')
ELSE 'None'
END as Group1,
CASE @groupby2
WHEN 'Facility' THEN dff.ListName
WHEN 'Financial Class' THEN ISNULL(fc.Description, 'No Financial Class')
WHEN 'Insurance Carrier' THEN ISNULL(ic.ListName,'No Insurance')
WHEN 'Policy Type' THEN ISNULL(ml.Description,'No Insurance')
ELSE 'None'
END as Group2,
medicareInsurance.InsuredId AS MedicaidId,
ISNULL(medicareInsurance.NoRecord,'') AS NoRecord
FROM
PatientVisitProcs pvp
INNER JOIN PatientVisit pv ON pvp.PatientVisitID = pv.PatientVisitID
INNER JOIN Batch b ON pvp.BatchId = b.BatchId
INNER JOIN PatientProfile pp ON pv.PatientProfileId = pp.PatientProfileId
LEFT OUTER JOIN InsuranceCarriers ic ON pv.PrimaryInsuranceCarriersID = ic.InsuranceCarriersID
LEFT JOIN PatientInsurance pi ON pv.PrimaryPICarrierId = pi.PatientInsuranceId
LEFT OUTER JOIN MedLists ml ON ic.PolicyTypeMID = ml.MedListsID
LEFT OUTER JOIN MedLists fc ON pv.FinancialClassMID = fc.MedListsID
INNER JOIN DoctorFacility dff ON pv.FacilityId = dff.DoctorFacilityId
LEFT OUTER JOIN Guarantor g ON pp.GuarantorID = g.GuarantorID
LEFT OUTER JOIN
(SELECT medicarepvi.patientvisitid,medicarepi.InsuredID, NoRecord='X' FROM PatientVisitInsurance medicarepvi INNER JOIN patientinsurance medicarepi ON medicarepvi.PatientInsuranceID = medicarepi.PatientInsuranceID
WHERE medicarepi.InsuranceCarriersId IN (4,3,7,2)) medicareInsurance ON medicareInsurance.patientvisitid = pv.patientvisitid
WHERE
--Filter on doctor
(
(NULL IS NOT NULL AND pv.DoctorID IN (NULL)) OR
(NULL IS NULL)
)
AND --Filter on Carrier
(
(NULL IS NOT NULL AND pv.PrimaryInsuranceCarriersID IN (NULL)) OR
(NULL IS NULL)
)
AND --Filter on facility
(
(NULL IS NOT NULL AND pv.FacilityID IN (NULL)) OR
(NULL IS NULL)
)
AND --Filter on company
(
(NULL IS NOT NULL AND pv.CompanyID IN (NULL)) OR
(NULL IS NULL)
)
AND --Filter on date range
(
(b.Entry >= ISNULL('01/01/2010', '1/1/1900') AND b.Entry < DATEADD(d,1,ISNULL('12/31/2010','1/1/3000')))
)
AND --Filter on FQHC procedures
(
(NULL IS NOT NULL AND pvp.ProceduresId IN (NULL)) OR
(NULL IS NULL)
)
ORDER BY
pp.[Last] + ', ' + pp.[First],
pvp.DateOfServiceFrom
SELECT
s.PatientVisitID,
s.[Date of Entry] AS [Date of Entry],
s.[Name],
s.Guarantor,
s.GuarantorId,
s.[Adjustment Type],
s.TicketNumber,
s.[Procedure Code],
s.[Adjustment Amount],
s.DateofServiceFrom,
s.Notes,
s.[Financial Class],
s.[Insurance Carrier],
s.InsuredID,
s.[Policy Type],
s.Facility,
s.Group1,
s.Group2,
s.MedicaidID,
s.NoRecord,
medicarepayment.amount AS MedicarePayment,
MIN(medicarepayment.CheckDate) as CheckDate,
(
SELECT min(esf.filetransmitted)
FROM EDIStatement es
INNER JOIN EDIStatementFile esf ON es.EDIStatementFileId = esf.EDIStatementFileId
WHERE es.GuarantorID = s.GuarantorId and esf.FileTransmitted > medicarepayment.checkdate
) AS StatementDate
FROM
#Summary s
INNER JOIN dbo.Guarantor g ON s.GuarantorId = g.GuarantorId
LEFT OUTER JOIN
(
SELECT
COALESCE(pm.CheckDate, pm.DateofEntry) AS Checkdate,
pm.DateOfEntry AS [Date Of Entry],
pv.PatientVisitID,
pv.TicketNumber,
-- pvp.Code,
-- CASE WHEN pm.Source = 2 THEN SUM(td.Amount)
-- ELSE 0.0000
-- END AS Amount,
SUM(td.Amount) AS Amount
-- pvp.DateOfServiceFrom
FROM
PaymentMethod pm
INNER JOIN VisitTransactions vt ON pm.PaymentMethodId = vt.PaymentMethodId
INNER JOIN Transactions tc ON vt.VisitTransactionsId = tc.VisitTransactionsId
INNER JOIN TransactionDistributions td ON tc.TransactionsId = td.TransactionsId
INNER JOIN PatientVisit pv ON vt.PatientVisitid = pv.PatientVisitId
INNER JOIN MedLists ml ON tc.ActionTypeMId = ml.MedListsId
-- LEFT JOIN PatientVisitProcs pvp ON td.PatientVisitProcsId = pvp.PatientVisitProcsId
INNER JOIN InsuranceCarriers ic ON vt.InsuranceCarriersId = ic.InsuranceCarriersId
LEFT OUTER JOIN MedLists ml2 ON ic.PolicyTypeMID = ml2.MedListsID
WHERE
tc.Type = 'P'
-- AND td.Amount <> 0.00
AND tc.Amount > 0
AND (ml2.Description LIKE 'Medicare%' OR ml2.Description LIKE 'Medicare Primary')
GROUP BY
pm.CheckDate, pm.DateofEntry,pv.PatientVisitID, pv.TicketNumber, /*pvp.Code,*/pm.Source--, pvp.DateOfServiceFrom
-- ORDER BY pm.DateofEntry
) medicarepayment ON s.ticketnumber = medicarepayment.ticketnumber AND s.PatientVisitID = medicarepayment.PatientVisitID /*AND s.[Procedure Code] = medicarepayment.code*/
GROUP BY
s.PatientVisitID,
s.[Date Of Entry],
s.[Name],
s.Guarantor,
s.GuarantorId,
s.[Adjustment Type],
s.TicketNumber,
s.[Procedure Code],
s.[Adjustment Amount],
s.DateofServiceFrom,
s.Notes,
s.[Financial Class],
s.[Insurance Carrier],
s.InsuredID,
s.[Policy Type],
s.Facility,
s.Group1,
s.Group2,
s.MedicaidID,
s.NoRecord,
medicarepayment.amount,
medicarepayment.CheckDate
ORDER BY s.Name, medicarepayment.CheckDate
DROP TABLE #Summary