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Duplicate claims problem
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Forum:
Visual FoxPro
Category:
Coding, syntax & commands
Miscellaneous
Thread ID:
00067637
Message ID:
00067641
Views:
25
>Heres a coolness problem. Working at a HMO and going through the claims tables you slowly discover that
>on a regular basis there are different claim numbers that have tell tale fields in common namely the service date
>field is the same , the member number is alike and the diagnosis code matches on 2 or more different claim numbers.
>After researching these claims it shows these signs inevitably mean more than one claim is being issued for the
>same visit. No NO no should'nt do that!
>How do you set this out in a usable output ie. I suppose the 1st best thing is to get rid of the good legitamate non
>"duplicate" claims and leave the suspect claims. The word "duplicate" is actually refering to the telltale symptoms
>of same diag, date and client name, not the actual claim numbers which are different.
>I havn't come up with anything other than sorting them out so they are easier to stare at and detect.
>
>DOWN WITH CLAIMS FRAUD --- YOU CAN MAKE A DIFFERENCE!!
>
>Swimming in free handouts at St. Louis...........Joe Mc.

A SELECT statement, grouping on the fields that are 'matching'?
SELECT diag + dtos(diag_date) + client_name AS MyField,;
   cnt(diag + dtos(diag_date) + client_name) as MyCounter from MyTable;
   into cursor DiagDupe;
   Group by 1 HAVING MyCounter > 1
Add whatever fields and other information you need...

HTH
Barbara
Barbara Paltiel, Paltiel Inc.
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