The document describes a medical billing database with tables for patients, insurance, doctors, diagnoses, procedures, bills, payments, and encounters. It also lists the relationships between these tables. Queries are provided to find unpaid balances, most common diagnoses and procedures billed, encounters on a given date, top paying insurance companies, and number of visits for a patient.

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