Hi mkeintz, Thanks for you advise. The above data is example of claims (insurance) data related to transactions on visit by patient (can be inpatient/outpatient to hospital/clinic) Claim SEQNO OUTRESV CUMPAID GPAY RSQN OCC_NO A1696384 1 2,085.90 0.00 0.00 1 00 A1696384 2 2,642.30 0.00 0.00 2 00 A1696384 3 859.49 1,782.81 1,782.81 3 00 A1696384 4 0.00 1,782.81 0.00 4 00 When a patient visit to hospital/clinic, 1) When a claim is recorded, certain amount of reserve is set aside to pay the claim 2) Then the reserve is review (reduce/increase) upon receiving the actual bill from hospital/clinic 3) The bill will be check and subsequently payment were made and reserve review (reduce/increase) 4) Reserve review and reduce to 0. Then, the claim is consider closed. Based on the above, seqno cannot be used. therefore, i've to come out with RSQN. The first 4 transactions related to '00' or 1st visit (most likely inpatient). Secondly, Claim SEQNO OUTRESV CUMPAID GPAY RSQN OCC_NO A1696384 5 500.76 1,782.81 0.00 1 01 A1696384 6 0.00 2,283.57 500.76 2 01 5) '01' is consider as second visit (outpatient@follow-up). Similar to the first visit process. 6) Bill is check, payment made and reserve review and reduce to 0 . Then, the claim is consider closed. Then, RSQN will restart due to new visit and the reserve put in and eventually payment will be made and closed. 2 transactions related to visit '01'. Thirdly, Claim SEQNO OUTRESV CUMPAID GPAY RSQN OCC_NO A1696384 7 624.00 2,283.57 0.00 1 02 A1696384 8 62.44 2,845.53 561.96 2 02 A1696384 9 0.00 2,845.53 0.00 3 02 A1696384 10 0.00 2,845.53 0.00 4 02 Seqno 7, 8, 9 & 10 similar to visit '01' (another outpatient). However seqno 9 & 10 can be amendment to the detail of the claims and the reduction of reserve to 0. The last 4 transactions related to visit '02'. Therefore inside the excel file, RSQN is checking the outresv and cumpaid to come out with the RSQN. Occ_no is checking claim and rsqn. Hope the above explain. Thanks again, i'll try.
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