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andrewallenbruce committed Jul 22, 2024
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Expand Up @@ -31,16 +31,19 @@ coverage](https://codecov.io/gh/andrewallenbruce/forager/branch/master/graph/bad

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## Installation
<br>

## :package: Installation

You can install the development version of `forager` from
[GitHub](https://github.com/) with:
You can install `forager` from [GitHub](https://github.com/) with:

``` r
# install.packages("pak")
pak::pak("andrewallenbruce/forager")
```

## :beginner: Usage

``` r
library(tidyverse)
library(clock)
Expand All @@ -53,66 +56,69 @@ library(fuimus)

``` r
(x <- mock_claims(15000))
#> # A tibble: 15,000 × 10
#> claimid payer charges balance date_ser…¹ date_rel…² date_sub…³ date_acc…⁴
#> <chr> <fct> <dbl> <dbl> <date> <date> <date> <date>
#> 1 00008 Oscar 115. 115. 2024-05-26 2024-06-04 2024-06-08 2024-06-14
#> 2 00343 American 284. 0 2024-05-26 2024-06-17 2024-06-19 2024-06-23
#> 3 00389 Wellcare 325. 325. 2024-05-26 2024-06-11 2024-06-19 2024-06-28
#> 4 00473 Medicaid 35. 35. 2024-05-26 2024-06-05 2024-06-08 2024-06-20
#> 5 00604 Humana 50. 50. 2024-05-26 2024-06-03 2024-06-10 2024-06-18
#> 6 01138 Omaha 107. 0 2024-05-26 2024-06-07 2024-06-08 2024-06-15
#> 7 01161 CVS Aetna 27. 27. 2024-05-26 2024-06-01 2024-06-03 2024-06-08
#> 8 01216 Lincoln … 73. 73. 2024-05-26 2024-05-26 2024-05-27 2024-06-07
#> 9 01262 Centene 97. 0 2024-05-26 2024-05-27 2024-05-29 2024-05-31
#> 10 01284 Medicaid 43. 43. 2024-05-26 2024-06-05 2024-06-10 2024-06-21
#> # ℹ 14,990 more rows
#> # ℹ abbreviated names: ¹​date_service, ²​date_release, ³​date_submission,
#> # ⁴​date_acceptance
#> # ℹ 2 more variables: date_adjudication <date>, date_reconciliation <date>
```

#> # A tibble: 15,000 × 10
#> claimid payer charges balance date_ser…¹ date_rel…² date_sub…³ date_acc…⁴
#> <chr> <fct> <dbl> <dbl> <date> <date> <date> <date>
#> 1 00135 American 90. 90. 2024-07-06 2024-07-21 2024-07-26 2024-08-11
#> 2 00159 New York… 87. 0 2024-07-06 2024-07-16 2024-07-18 2024-08-03
#> 3 00180 Medicare 187. 187. 2024-07-06 2024-07-20 2024-07-25 2024-08-06
#> 4 00195 BCBS WY 174. 174. 2024-07-06 2024-07-22 2024-07-25 2024-08-03
#> 5 00199 Athene 32. 32. 2024-07-06 2024-07-13 2024-07-17 2024-07-25
#> 6 00251 BCBS WY 260. 260. 2024-07-06 2024-07-10 2024-07-13 2024-07-23
#> 7 00369 HCSC 104. 104. 2024-07-06 2024-07-16 2024-07-20 2024-07-28
#> 8 00373 Athene 144. 144. 2024-07-06 2024-07-19 2024-07-20 2024-07-24
#> 9 00481 Humana 119. 0 2024-07-06 2024-07-08 2024-07-09 2024-07-14
#> 10 00522 Molina 102. 102. 2024-07-06 2024-07-19 2024-07-20 2024-07-30
#> # ℹ 14,990 more rows
#> # ℹ abbreviated names: ¹​date_service, ²​date_release, ³​date_submission,
#> # ⁴​date_acceptance
#> # ℹ 2 more variables: date_adjudication <date>, date_reconciliation <date>

<br>

``` r
(x <- prep_claims(x))
#> # A tibble: 15,000 × 13
#> claimid payer charges balance date_service aging_bin dar days_rel…¹
#> <chr> <fct> <dbl> <dbl> <date> <fct> <dbl> <dbl>
#> 1 00001 Oscar 166. 166. 2024-05-17 0-30 11 0
#> 2 00002 Medicare 23. 23. 2024-04-03 0-30 20 2
#> 3 00003 UnitedHealth 212. 212. 2024-03-27 0-30 18 2
#> 4 00004 GuideWell 84. 84. 2024-05-13 31-60 34 6
#> 5 00005 Lincoln Nat'l 194. 194. 2024-04-03 0-30 29 5
#> 6 00006 HCSC 98. 0 2024-04-04 31-60 34 8
#> 7 00007 Mass Mutual 37. 37. 2024-05-13 31-60 37 7
#> 8 00008 Oscar 115. 115. 2024-05-26 31-60 37 9
#> 9 00009 BCBS MI 190. 190. 2024-04-06 31-60 42 10
#> 10 00010 CVS Aetna 57. 57. 2024-04-10 31-60 40 5
#> # ℹ 14,990 more rows
#> # ℹ abbreviated name: ¹​days_release
#> # ℹ 5 more variables: days_submission <dbl>, days_acceptance <dbl>,
#> # days_adjudication <dbl>, days_reconciliation <dbl>, dates <list>
```

#> # A tibble: 15,000 × 13
#> claimid payer charges balance date_service aging_bin dar days_rel…¹
#> <chr> <fct> <dbl> <dbl> <date> <fct> <dbl> <dbl>
#> 1 00001 Humana 87. 87. 2024-06-11 0-30 16 1
#> 2 00002 Cigna 216. 0 2024-05-12 0-30 29 1
#> 3 00003 Equitable 140. 140. 2024-06-07 0-30 24 3
#> 4 00004 Highmark 185. 185. 2024-05-21 0-30 27 3
#> 5 00005 HCSC 72. 72. 2024-04-27 0-30 29 6
#> 6 00006 BCBS WY 124. 124. 2024-05-03 31-60 31 7
#> 7 00007 Athene 230. 230. 2024-04-12 0-30 30 8
#> 8 00008 New York Life 43. 43. 2024-06-09 31-60 50 12
#> 9 00009 New York Life 256. 256. 2024-04-20 31-60 34 17
#> 10 00010 Lincoln Nat'l 236. 236. 2024-05-05 31-60 49 12
#> # ℹ 14,990 more rows
#> # ℹ abbreviated name: ¹​days_release
#> # ℹ 5 more variables: days_submission <dbl>, days_acceptance <dbl>,
#> # days_adjudication <dbl>, days_reconciliation <dbl>, dates <list>

<br>

``` r
summarise_claims(x) |>
glimpse()
#> Rows: 1
#> Columns: 9
#> $ n_claims <int> 15000
#> $ gross_charges <dbl> 1998810
#> $ ending_ar <dbl> 1315266
#> $ mean_release <dbl> 8.0004
#> $ mean_submission <dbl> 3.01
#> $ mean_acceptance <dbl> 7.518067
#> $ mean_adjudication <dbl> 14.9988
#> $ mean_reconciliation <dbl> 2.23959
#> $ mean_dar <dbl> 34.2838
```

#> Rows: 1
#> Columns: 9
#> $ n_claims <int> 15000
#> $ gross_charges <dbl> 1986374
#> $ ending_ar <dbl> 1323904
#> $ mean_release <dbl> 8.010267
#> $ mean_submission <dbl> 3.013267
#> $ mean_acceptance <dbl> 7.467933
#> $ mean_adjudication <dbl> 15.0508
#> $ mean_reconciliation <dbl> 2.227745
#> $ mean_dar <dbl> 34.28633

``` r
x |>
group_by(
Expand All @@ -123,22 +129,23 @@ x |>
summarise_claims() |>
arrange(payer) |>
select(year, month, payer, n_claims, ending_ar, mean_dar)
#> # A tibble: 81 × 6
#> year month payer n_claims ending_ar mean_dar
#> <int> <int> <fct> <int> <dbl> <dbl>
#> 1 2024 3 Oscar 195 18188. 34.
#> 2 2024 4 Oscar 181 15630. 34.
#> 3 2024 5 Oscar 148 14025. 34.
#> 4 2024 3 Medicare 186 16966. 34.
#> 5 2024 4 Medicare 208 17676. 34.
#> 6 2024 5 Medicare 157 13925. 36.
#> 7 2024 3 UnitedHealth 179 15377. 33.
#> 8 2024 4 UnitedHealth 182 17476. 34.
#> 9 2024 5 UnitedHealth 156 14550. 34.
#> 10 2024 3 GuideWell 202 19187. 34.
#> # ℹ 71 more rows
```

#> # A tibble: 108 × 6
#> year month payer n_claims ending_ar mean_dar
#> <int> <int> <fct> <int> <dbl> <dbl>
#> 1 2024 4 Humana 131 11829. 35.
#> 2 2024 5 Humana 197 16190. 34.
#> 3 2024 6 Humana 209 18879. 34.
#> 4 2024 7 Humana 39 2893. 33.
#> 5 2024 4 Cigna 106 10455. 34.
#> 6 2024 5 Cigna 208 17423. 34.
#> 7 2024 6 Cigna 190 17407. 33.
#> 8 2024 7 Cigna 44 3708. 36.
#> 9 2024 4 Equitable 125 11415. 35.
#> 10 2024 5 Equitable 202 13414. 35.
#> # ℹ 98 more rows

<br>

``` r
Expand All @@ -151,22 +158,23 @@ x |>
summarise_claims() |>
arrange(payer) |>
select(year, qtr, payer, n_claims, ending_ar, mean_dar)
#> # A tibble: 54 × 6
#> year qtr payer n_claims ending_ar mean_dar
#> <int> <int> <fct> <int> <dbl> <dbl>
#> 1 2024 1 Oscar 195 18188. 34.
#> 2 2024 2 Oscar 329 29655. 34.
#> 3 2024 1 Medicare 186 16966. 34.
#> 4 2024 2 Medicare 365 31601. 35.
#> 5 2024 1 UnitedHealth 179 15377. 33.
#> 6 2024 2 UnitedHealth 338 32026. 34.
#> 7 2024 1 GuideWell 202 19187. 34.
#> 8 2024 2 GuideWell 356 31347. 35.
#> 9 2024 1 Lincoln Nat'l 199 17432. 34.
#> 10 2024 2 Lincoln Nat'l 392 36733. 34.
#> # ℹ 44 more rows
```

#> # A tibble: 54 × 6
#> year qtr payer n_claims ending_ar mean_dar
#> <int> <int> <fct> <int> <dbl> <dbl>
#> 1 2024 2 Humana 537 46899. 34.
#> 2 2024 3 Humana 39 2893. 33.
#> 3 2024 2 Cigna 504 45285. 34.
#> 4 2024 3 Cigna 44 3708. 36.
#> 5 2024 2 Equitable 519 41301. 35.
#> 6 2024 3 Equitable 40 2298. 35
#> 7 2024 2 Highmark 489 41779. 35.
#> 8 2024 3 Highmark 29 2757. 34.
#> 9 2024 2 HCSC 547 52913. 34.
#> 10 2024 3 HCSC 41 3544. 34.
#> # ℹ 44 more rows

## Days in AR Calculation

> Monthly
Expand All @@ -183,26 +191,27 @@ tibble(
earb,
dart = 35,
by = "month")
#> # A tibble: 12 × 15
#> date gct earb ndip adc dart dar dar_pass ratio_id…¹ ratio_ac…²
#> <date> <int> <int> <int> <dbl> <dbl> <dbl> <lgl> <dbl> <dbl>
#> 1 2024-01-01 2.5e5 2.9e5 31 8080. 35 36. FALSE 1.1 1.2
#> 2 2024-02-01 2.5e5 2.9e5 29 8624. 35 34. TRUE 1.2 1.2
#> 3 2024-03-01 2.5e5 2.9e5 31 8062. 35 36. FALSE 1.1 1.2
#> 4 2024-04-01 2.5e5 2.9e5 30 8320. 35 35. TRUE 1.2 1.2
#> 5 2024-05-01 2.5e5 2.9e5 31 8026. 35 36. FALSE 1.1 1.2
#> 6 2024-06-01 2.5e5 2.9e5 30 8310. 35 35. TRUE 1.2 1.2
#> 7 2024-07-01 2.5e5 2.9e5 31 8053. 35 36. FALSE 1.1 1.2
#> 8 2024-08-01 2.5e5 2.9e5 31 8041. 35 36. FALSE 1.1 1.2
#> 9 2024-09-01 2.5e5 2.9e5 30 8324. 35 35. TRUE 1.2 1.2
#> 10 2024-10-01 2.5e5 2.9e5 31 8084. 35 36. FALSE 1.1 1.2
#> 11 2024-11-01 2.5e5 2.9e5 30 8353. 35 35. TRUE 1.2 1.2
#> 12 2024-12-01 2.5e5 2.9e5 31 8040. 35 36. FALSE 1.1 1.2
#> # ℹ abbreviated names: ¹​ratio_ideal, ²​ratio_actual
#> # ℹ 5 more variables: ratio_diff <dbl>, earb_target <dbl>, earb_diff <dbl>,
#> # gct_pct <dbl>, earb_pct <dbl>
```

#> # A tibble: 12 × 15
#> date gct earb ndip adc dart dar dar_pass ratio_id…¹ ratio_ac…²
#> <date> <int> <int> <int> <dbl> <dbl> <dbl> <lgl> <dbl> <dbl>
#> 1 2024-01-01 2.5e5 2.9e5 31 8021. 35 36. FALSE 1.1 1.2
#> 2 2024-02-01 2.5e5 2.9e5 29 8604. 35 34. TRUE 1.2 1.2
#> 3 2024-03-01 2.5e5 2.9e5 31 8066. 35 36. FALSE 1.1 1.2
#> 4 2024-04-01 2.5e5 2.9e5 30 8339. 35 35. TRUE 1.2 1.2
#> 5 2024-05-01 2.5e5 2.9e5 31 8047. 35 36. FALSE 1.1 1.2
#> 6 2024-06-01 2.5e5 2.9e5 30 8329. 35 35. TRUE 1.2 1.2
#> 7 2024-07-01 2.5e5 2.9e5 31 8099. 35 36. FALSE 1.1 1.2
#> 8 2024-08-01 2.5e5 2.9e5 31 8061. 35 36. FALSE 1.1 1.2
#> 9 2024-09-01 2.5e5 2.9e5 30 8302. 35 35. TRUE 1.2 1.2
#> 10 2024-10-01 2.5e5 2.9e5 31 8049. 35 36. FALSE 1.1 1.2
#> 11 2024-11-01 2.5e5 2.9e5 30 8313. 35 35. TRUE 1.2 1.2
#> 12 2024-12-01 2.5e5 2.9e5 31 8054. 35 36. FALSE 1.1 1.2
#> # ℹ abbreviated names: ¹​ratio_ideal, ²​ratio_actual
#> # ℹ 5 more variables: ratio_diff <dbl>, earb_target <dbl>, earb_diff <dbl>,
#> # gct_pct <dbl>, earb_pct <dbl>

<br>

> Quarterly
Expand All @@ -219,25 +228,34 @@ tibble(
earb,
dart = 35,
by = "quarter")
#> # A tibble: 4 × 15
#> date earb gct ndip adc dart dar dar_pass ratio_id…¹ ratio_ac…²
#> <date> <int> <int> <int> <dbl> <dbl> <dbl> <lgl> <dbl> <dbl>
#> 1 2024-03-01 285562 7.5e5 91 8249. 35 35. TRUE 0.38 0.38
#> 2 2024-06-01 285591 7.5e5 91 8253. 35 35. TRUE 0.38 0.38
#> 3 2024-09-01 285469 7.5e5 92 8149. 35 35. FALSE 0.38 0.38
#> 4 2024-12-01 285639 7.5e5 92 8131. 35 35. FALSE 0.38 0.38
#> # ℹ abbreviated names: ¹​ratio_ideal, ²​ratio_actual
#> # ℹ 5 more variables: ratio_diff <dbl>, earb_target <dbl>, earb_diff <dbl>,
#> # gct_pct <dbl>, earb_pct <dbl>
```

## Code of Conduct
#> # A tibble: 4 × 15
#> date earb gct ndip adc dart dar dar_pass ratio_id…¹ ratio_ac…²
#> <date> <int> <int> <int> <dbl> <dbl> <dbl> <lgl> <dbl> <dbl>
#> 1 2024-03-01 284676 7.5e5 91 8245. 35 35. TRUE 0.38 0.38
#> 2 2024-06-01 285645 7.5e5 91 8262. 35 35. TRUE 0.38 0.38
#> 3 2024-09-01 285768 7.5e5 92 8162. 35 35. FALSE 0.38 0.38
#> 4 2024-12-01 285689 7.5e5 92 8133. 35 35. FALSE 0.38 0.38
#> # ℹ abbreviated names: ¹​ratio_ideal, ²​ratio_actual
#> # ℹ 5 more variables: ratio_diff <dbl>, earb_target <dbl>, earb_diff <dbl>,
#> # gct_pct <dbl>, earb_pct <dbl>

------------------------------------------------------------------------

## :balance_scale: Code of Conduct

Please note that the `forager` project is released with a [Contributor
Code of
Conduct](https://andrewallenbruce.github.io/forager/CODE_OF_CONDUCT.html).
By contributing to this project, you agree to abide by its terms.

## :classical_building: Governance

This project is primarily maintained by [Andrew
Bruce](https://github.com/andrewallenbruce). Other authors may
occasionally assist with some of these duties.

[^1]: <https://dictionary.cambridge.org/dictionary/english/forager>

[^2]: Me.

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