Advanced Billing Rule Failed Compliance widget
The Advanced Billing Rule Failed Compliance widget displays all the services that failed an advanced billing rule that stops the claim from being billed during the billing process.
The widget's drop-down list allows you to filter by a specified Failed Reason for All. All Failed Reasons display be default.
The following fields should display in the widget:
- Client Name (Last, First)
- Client ID
- Service Date
- CPT
- Guarantor
- Number of Units
- Program
- Policy Number
- Practitioner
- Practitioner NPI
- Dx Code
- Rule Description
- Failed Reason
The items should be listed in order by Client Name, Client ID and Guarantor.
Widget SQL Statement
This widget contains a filter which cannot be replicated by creating a new widget. However, we are including the SQL for those who want to create a customized Advanced Billing Rule Failed Compliance without filtering capabilities.
SELECT %NOLOCK billing_tx_failed_compliance.PATID, patient_current_demographics.patient_name, billing_tx_history.date_of_service, billing_tx_failed_compliance.GUARANTOR_ID, billing_tx_failed_compliance.guarantor_name , billing_tx_history.units_of_service, billing_tx_history.program_code, billing_tx_history.program_value, billing_tx_history.PROVIDER_ID, billing_tx_history.v_PROVIDER_NAME, billing_tx_failed_compliance.v_patient_svc_diagnosis_code , billing_tx_failed_compliance.v_patient_svc_diagnosis_value, billing_tx_failed_compliance.fail_reason_code, billing_tx_failed_compliance.fail_reason_value, billing_tx_history.SERVICE_CODE , billing_tx_history.duration , billing_tx_failed_compliance.JOIN_TO_TX_HISTORY, billing_tx_history.EPISODE_NUMBER, billing_tx_failed_compliance.v_rule_description FROM (SYSTEM.billing_tx_failed_compliance billing_tx_failed_compliance INNER JOIN SYSTEM.billing_tx_history billing_tx_history ON (billing_tx_history.PATID = billing_tx_failed_compliance.PATID AND billing_tx_history.JOIN_TO_TX_HISTORY = billing_tx_failed_compliance.JOIN_TO_TX_HISTORY AND billing_tx_history.FACILITY = billing_tx_failed_compliance.FACILITY)) INNER JOIN SYSTEM.patient_current_demographics patient_current_demographics ON (patient_current_demographics.PATID = billing_tx_failed_compliance.PATID AND patient_current_demographics.FACILITY = billing_tx_failed_compliance.FACILITY) WHERE billing_tx_failed_compliance.FACILITY=? ORDER BY patient_current_demographics.patient_name, billing_tx_failed_compliance.PATID, billing_tx_failed_compliance.guarantor_name
For more information, see the Billing Widget Consoles training guide.