1. Medical Billing Database
Noelle Vaughn

3. Tables Created From Entity Sets:
Patient: pt_id, pt_name (C), birth_date, pt_address (C), phone_no (MV),
gender
Insurance: insurance_id, ins_name, address (C), phone_no
Doctor: doc_name (C), doc_id, NPI, address (C), phone_no
Diagnosis: dx_code, diag_desc
Procedure: px_code, proc_desc
Bill: bill_no, bill_date, due_date, bill_amount, bill_type
Payment: transaction_id, date_received, pmnt_type, bill_no,
payment_amount
Encounter: visit_date, pt_id
Pt_phone: pt_id, pt_phone

4. Tables Created From Relationship Sets:
Attends: doc_id, pt_id, visit_date
Is_made_during: dx_code, pt_id, visit_date
Is_performed_during: px_code, pt_id, visit_date
Generates: pt_id, bill_no, visit_date
Has: pt_id, insurance_id
Is_submitted_to: bill_no, insurance_id
Makes_a: insurance_id, transaction_id

5. QUERIES I CREATED TO TEST THE DATABASE
What accounts have unpaid balances?
(SELECT bill.bill_no, bill_amount - (SELECT SUM(payment_amount)
FROM payment WHERE payment.bill_no = bill.bill_no)
FROM bill WHERE bill_amount - (SELECT SUM(payment_amount)
FROM payment WHERE payment.bill_no = bill.bill_no) > 0)
UNION
(SELECT bill.bill_no, bill_amount FROM bill WHERE (SELECT COUNT(*)
FROM payment WHERE payment.bill_no = bill.bill_no) = 0);
Results
bill_no | ?column?
---------+----------
106 | 35.00
115 | 50.00
118 | 100.00
107 | 75.00
109 | 150.00
108 | 150.00
114 | 50.00
117 | 50.00
103 | 50.00
111 | 30.00
110 | 75.00
113 | 50.00
104 | 25.00
116 | 50.00

6. Which diagnosis codes have been billed most within the past
year?
SELECT is_made_during.dx_code, diag_desc
FROM is_made_during, diagnosis
WHERE is_made_during.dx_code = diagnosis.dx_code
GROUP BY is_made_during.dx_code, diagnosis.diag_desc
HAVING COUNT(*) =
(SELECT MAX(num) FROM
(SELECT COUNT(*) AS num FROM is_made_during GROUP BY
dx_code) AS mycount);
dx_code | diag_desc
---------+------------------------------
V70.0 | routine general medical exam

7. Which procedure codes were billed most within the past year?
SELECT is_performed_during.px_code, procedure.proc_desc
FROM is_performed_during, procedure
WHERE is_performed_during.px_code = procedure.px_code
GROUP BY is_performed_during.px_code,
procedure.proc_desc
HAVING COUNT(*) =
(SELECT MAX(num) FROM
(SELECT COUNT(*) AS num FROM is_performed_during GROUP
BY px_code) AS mycount);
Results
px_code | proc_desc
---------+-----------------------------------
G0463 | visit for assessment & management

8. What encounters took place on a certain date?
SELECT pt_id, visit_date
FROM encounter
WHERE visit_date = '2014-10-01';
Results:
pt_id | visit_date
-------+------------
6 | 2014-10-01
7 | 2014-10-01

9. Which insurance companies have made the most payments within
the past year?
SELECT makes_a.insurance_id, insurance.ins_name
FROM makes_a, insurance
WHERE makes_a.insurance_id = insurance.insurance_id
GROUP BY makes_a.insurance_id, insurance.ins_name
HAVING COUNT(*) =
(SELECT MAX(num) FROM
(SELECT COUNT(*) AS num FROM makes_a
GROUP BY insurance_id) AS mycount);
Results
insurance_id | ins_name
-------------- ----------
1 | Aetna

10. How many visits has a certain patient had within the past
year?
SELECT COUNT(visit_date)
FROM encounter
WHERE pt_id = '1';
Results
count
-------
3