Medicare X12 Claim Issues

Developers
David
2013-01-31
2013-04-06
1 2 > >> (Page 1 of 2)
  • David

    David - 2013-01-31

    Our Medicare X12 Claims began falling into a black hole at FCSO after the 4.1.1 upgrade.

    We are currently working with FCSO to diagnose the problems.  Claims submitted before the upgrade ran clean, were acknowledged and we got paid.  Now we get no 277, no reject notices or any other error, and no money!

    X12 bugs were mentioned in the list of "improvements" but for us, this was a step backwards.
    FCSO is telling us that we now have numbers in the wrong places and we didn't change anything.

    We'll keep you posted on the progress.

    "Dealing with the government is like breeding elephants;
    It's done at a very high level, with a lot of loud thundering and trumpeting and
    it takes two years to produce results"

     

     
  • David

    David - 2013-01-31

    FCSO is telling us that the block which now contains the TIN (underlined) should have our sender ID
    ~NM1*41*2*JOANNA VANVLEET, DO, LLC*****46*453558058~
    Problem is TIN is in User Data and a change there will affect the field where it is supposed to be.
    ~REF*EI*453558058~

     
  • David

    David - 2013-01-31

    I need this fixed yesterday  - can I replace a file to get us back to where it worked?

     
  • Robert Rambo

    Robert Rambo - 2013-01-31

    D if you have a backup why dont you replace your gen_x12 in the library folder to when it used to work probally 2 weeks ago?
    Also look at this http://www.x12view.com/ for a nice x12 viewer
    Also nucc.org dataset
    Do you submit directly to medicare? Or through a clearing house?

     
  • David

    David - 2013-01-31

    R.
    Thanks for the X12 viewer link (that will help)
    We submit directly to the East Coast CMS Contractor, First Coast Service Options (FCSO).
    Were going to try reverting back to the old gen_x12 file.

     
  • David

    David - 2013-02-01

    K
    gen_x12 was replaced by the 4.1.1 upgrade we did on January 1st and simply replacing our old file didn't fly.  There must have been other things impacting our X12 setup.  We had to rework Loop 1000A to put our submitter ID in place of ETIN so claims would be accepted by FCSO.  We are now confident that we have the FCSO x12 issues behind us (for now).
          

     
  • Robert Rambo

    Robert Rambo - 2013-02-01

    Glad to hear it is fixed I Know how that is thanxs for the update

     
  • Robert Rambo

    Robert Rambo - 2013-02-01

    It seems strange do to the fact the x12 standard says the submitter ID should be in ISA string
    Keep me updated please!

     
  • Rod Roark

    Rod Roark - 2013-02-01

    Strongly recommend you get such requirements in writing from them.  Actually they should already have something like a "companion guide" to clarify these things.  Instructions from  a phone tech are often pure garbage and payers have little incentive to improve that.

    Rod
    www.sunsetsystems.com

     
  • Robert Rambo

    Robert Rambo - 2013-03-06

    Is anyone using a x12 parser for the 837P to make the output of the gen_x12 file easier to read?

     
  • Sherwin Gaddis

    Sherwin Gaddis - 2013-03-07

    Hi,

    I have a similar problem. Donna the billing person wrote:

    Sherwin,
    
    A batch of claims was submitted on Fri & Mon.  Payerpath errored/rejected some Medicare claims stating "invalid or missing NPI data".  Called Payerpath.  They said "no data came to them & loop 2310A was blank".  I verified that the NPI data is in address book & that a referring doctor was listed on the fee sheet.  What can you do to make sure this data transmits to Payerpath?
    
    Here's a list of the patients that had claims rejected in Mondays batch:
    M SMITH #2475  DOS 2/28  REFERRING DOCTOR= EAST
    C SCOTT #1687 DOS 2/27  REFERRING DOCTOR= EAST
    I LAWRENCE #807 DOS 2/26  REFERRING DOCTOR= TAYLOR
    
    Let me know if there is any other info that is needed to resolve this issue.
    *****************
    Sherwin,
    I discovered today that data in the "referring provider" field in patient demographics is whats being transmitted to payerpath, instead of the "referring doctor" listed in the fee sheet.  I hope this info help you resolve the issue.
    
    Thanks
    Donna
    
    ***************
    

    I am in a section of the program I know very little to nothing about but I feel I am about to get a crash course. We did the upgrade to 4.1.1(10) one week ago. Before then everything in billing was fine.

    Now I noticed that in the message above someone was talking about Loop 1000A and Donna is talking about a loop 2310A. Where do I find these Loops and how do I get them back on track.

    I looked at the gen_x12_837.inc.php file and compared it with the 4.1.0 code and there is only one major difference.

    Lines 31- 35 old code
      $out .= "ISA" .
        "*00" .
        "*          " .
        "*00" .
        "*          " .
        "*" . $claim->x12gsisa05() .
        "*" . $claim->x12gssenderid() .
        "*" . $claim->x12gsisa07() .
        "*" . $claim->x12gsreceiverid() .
        "*030911" .
        "*1630"
    

    New Code

      $out .= "ISA" .
        "*" . $claim->x12gsisa01() .
        "*" . $claim->x12gsisa02() .
        "*" . $claim->x12gsisa03() .
        "*" . $claim->x12gsisa04() .
        "*" . $claim->x12gsisa05() .
        "*" . $claim->x12gssenderid() .
        "*" . $claim->x12gsisa07() .
        "*" . $claim->x12gsreceiverid() .
        "*030911" .
        "*1630" .
    

    Any comments on how this plays into the issue stated in the beginning would be greatly appreciated.

    Sherwin

     
  • Robert Rambo

    Robert Rambo - 2013-03-07

    I realized a while back that you have to be careful with ezclaim about the diff between 4010 and 5010
    You want to get the data set from your clearing house and you insurance company
    Yes they are very hard to find and no one wants to help you get them it seem.
    Then there is the x12org $300 does anyone have this btw?

        Loop 0000A - INTERCHANGE CONTROL HEADER
        ISA - Interchange Control Header
        ISA01 - Authorization Information Qualifier
        ISA02 - Authorization Information
        ISA03 - Security Information Qualifier
        ISA04 - Password
        ISA05 - ID Qualifer
        ISA06 - Sender ID
        ISA07 - Interchange ID Qualifier
        ISA08 - Interchange Receiver ID #
        ISA09 - Submission Date
        ISA10 - Submission Time
        ISA14 - Acknowledgement Requested
        ISA15 - Test/Prod Indicator
        Loop 0000B - FUNCTIONAL GROUP HEADER
        GS - Function Group Header
        GS02 - Sender Code
        GS03 - Receiver Code
        Loop 0000D - TRANSACTION HEADER
        BHT - Beginning of Hierarchical Transaction
        BHT03 - Submission Number
        BHT04 - Submission Date
        BHT05 - Submission Time
        Loop 0000E - TRANSACTION HEADER
        REF*87 - Transmission Type Identification
        REF02 - Transmission Type Code
        Loop 1000A - SUBMITTER NAME
        NM1*41 - Submitter Name
        NM102 - Submitter Type Qualifier
        NM103 - Submitter Name
        NM109 - Submitter ID
        PER*IC - Submitter EDI Contact Information
        PER02 - Submitter Name
        PER03 - Submitter Contact Number Qualifier
        PER04 - Submitter Telephone Number
        Loop 1000B - RECEIVER NAME
        NM1*40 - Receiver Name
        NM103 - Receiver Name
        NM109 - Receiver ID #
        Loop 2000A - BILLING/PAY-TO PROVIDER
        HL - Billing/Pay-to Provider Hierarchical Level
        HL03 - Billing/Pay-To Provider Hierarchical Level
        PRV*BI - Billing/Pay-to Provider Specialty Information
        PRV03 - Provider Taxonomy Code
        Loop 2000B - SUBSCRIBER HIERARCHICAL LEVEL
        HL - Subscriber Hierarchical Level
        HL03 - Subscriber Hierarchical Level
        PAT - Patient Information
        PAT08 - Patient Weight
        SBR - Subscriber Information
        SBR01 - Destination Payer Responsibility Sequence #
        SBR02 - Patient Relationship to Insured
        SBR03 - Insured Group or Policy Number
        SBR04 - Group Name
        SBR05 - Insurance Type Code
        SBR09 - Claim Filing Indicator
        Loop 2000C - PATIENT HIERARCHICAL LEVEL
        HL - Patient Hierarchical Level
        HL03 - Patient Hierarchical Level
        PAT - Patient Information
        PAT01 - Individual Relationship Code
        Loop 2010AA - BILLING PROVIDER NAME
        N3 - Billing Provider Address
        N301 - Billing Provider Address Line
        N4 - Billing Provider City, State, ZIP Code
        N401 - Billing Provider City
        N402 - Billing Provider State
        N403 - Billing Provider Zip
        NM1*85 - Billing Provider Name
        NM102 - Entity Type Qualifier
        NM103 - Billing Provider Last Name or Organizational Name*
        NM104 - Billing Provider First Name*
        NM105 - Billing Provider Middle Init*
        NM108 - Provider Primary Type
        NM109 - Provider Primary #
        REF - Billing Provider Secondary Identification
        REF01 - Reference Qualifier
        REF02 - Billing Provider Additional Identifier
        Loop 2010AB - PAY-TO PROVIDER NAME
        N3 - Pay-To Provider Address
        N301 - Pay To Provider Address Line
        N4 - Pay-To Provider Address City, State, ZIP Code
        N401 - Pay To Provider City
        N402 - Pay To Provider State
        N403 - Pay To Provider Zip
        NM1*87 - Pay-To Provider Name
        NM102 - Entity Type Qualifier
        NM103 - Pay To Provider Last Name or Organizational Name*
        NM104 - Pay To Provider First Name*
        NM105 - Pay To Provider Middle Init*
        NM108 - Pay To Provider ID Type
        NM109 - Pay To Provider Tax ID #
        Loop 2010BA - SUBSCRIBER NAME
        DMG - Subscriber Demographic Information
        DMG02 - Subscriber DOB
        DMG03 - Subscriber Gender
        N3 - Subscriber Address
        N301 - Subscriber Street Address
        N302 - Subscriber Address #2
        N4 - Subscriber City, State, ZIP Code
        N401 - Subscriber City
        N402 - Subscriber State
        N403 - Subscriber Zip
        NM1*IL - Subscriber Name
        NM103 - Subscriber Last Name
        NM104 - Subscriber First Name
        NM105 - Subscriber Middle Init
        NM108 - Identification Code Qualifier
        NM109 - Subscriber Insured ID Number
        REF*1W - Subscriber Secondary Identification
        REF02 - Subscriber Supplemental Identifier
        REF*SY - Subscriber Secondary Identification
        REF02 - Subscriber Supplemental Identifier
        Loop 2010BB - PAYER NAME
        N3 - Payer Address
        N301 - Payer Address, Line 1
        N302 - Payer Address, Line 2
        N4 - Payer City, State, ZIP Code
        N401 - Payer City
        N402 - Payer State
        N403 - Payer Zip Code
        NM1*PR - Payer Name
        NM103 - Payer Name - Destination
        NM108 - Identification Code Qualifier
        NM109 - Payer ID - Destination
        Loop 2010CA - PATIENT NAME
        DMG - Patient Demographic Information
        DMG03 - Patient DOB
        DMG03 - Patient Gender
        N3 - Patient Address
        N301 - Patient Street Address
        N302 - Patient Address #2
        N4 - Patient City, State, ZIP Code
        N401 - Patient City
        N402 - Patient State
        N403 - Patient Zip
        NM1*QC - Patient Name
        NM103 - Patient Last Name
        NM104 - Patient First Name
        NM105 - Patient Middle Init
        NM108 - Identification Code Qualifier
        NM109 - Patient Primary Indentifier
        Loop 2300 - CLAIM INFORMATION
        AMT*F5 - Patient Amount Paid
        AMT02 - Patient Amount Paid
        CLM - Claim Information
        CLM01 - Claim Submitter's Identifier
        CLM02 - Total Claim Charges
        CLM05 - Resubmission Code - Claim Frequency Type Code
        CLM05 - Place of Service (Facility Type Code)
        CLM06 - Provider Signature Indicator
        CLM07 - Provider Assignment Indicator
        CLM08 - Assignment of Benefits
        CLM09 - Release of Information Indicator
        CLM10 - Patient Signature Source
        CLM11 - Accident/Employment/Related Causes
        CLM11 - Accident State
        CLM12 - Special Program Indicator
        CLM16 - Provider Agreement Code
        CLM20 - Delay Reason Code
        CN1 - Contract Information
        CN101 - Contract Type Code
        CN102 - Monetary
        CN103 - Percent
        CR1 - Ambulance Transport Information
        CR102 - Patient Weight
        CR103 - Ambulance Transport Code
        CR104 - Ambulance Transport Reason Code
        CR106 - Transport Distance
        CR109 - Round Trip Purpose Description
        CR110 - Stretcher Purpose Description
        CRC*07 - Ambulance Certification
        CRC02 - Certification Condition Indicator
        CRC03 - Condition Code
        CRC*75 - Homebound Indicator
        CRC03 - Home Bound Indicator
        CRC*ZZ - EPSDT Referral
        CRC01 - Code Category
        CRC02 - Certification Condition Indicator
        CRC03 - Condition Code
        DTP*090 - Date - Assumed Care
        DTP01 - Qualifier
        DTP02 - Report Start
        DTP*091 - Relinquished Care Date
        DTP01 - Qualifier
        DTP02 - Report End
        DTP*304 - Date - Date Last Seen
        DTP03 - Date Last Seen
        DTP*431 - Date - Onset of Current Illness/Symptom
        DTP02 - Onset of Current Illness/Symptom
        DTP*435 - Date - Admission
        DTP03 - Admission Date
        DTP*439 - Date - Accident
        DTP02 - Accident Date
        DTP*453 - Date - Acute Manifestation
        DTP03 - Acute Manifestation Date
        DTP*454 - Date - Initial Treatment
        DTP02 - Initial Treatment Date
        HI - Health Care Diagnosis Code
        HI01 - Diagnosis Codes 1
        HI02 - Diagnosis Codes 2
        HI03 - Diagnosis Codes 3
        HI04 - Diagnosis Codes 4
        K3 - File Information
        K301 - Fixed Format Information
        NTE*ADD - Claim Note
        NTE02 - Notes
        PWK - Claim Supplemental Information
        PWK01 - Attachment Report Type Code
        PWK02 - Report Transmission Code
        PWK05 - Identification Code Qualifier
        PWK06 - Attachment Control Number
        REF*4N - Service Authorization Exception Code
        REF02 - Service Authorization Exception Code
        REF*9F - Prior Authorization or Referral Number
        REF02 - Referral Number
        REF*EW - Mammography Certification Number
        REF02 - Mammography Certification
        REF*F5 - Mandatory Medicare (Section 4081) Crossover Indicator
        REF02 - Medicare Section 4081 Indicator
        REF*F8 - Original Reference Number (ICN/DCN)
        REF02 - Original Claim Reference Number
        REF*G1 - Prior Authorization or Referral Number
        REF01 - Reference ID Qualifier
        REF02 - Prior Authorization Number
        REF*LX - Investigational Device Exemption Number
        REF02 - Investigational Device Exemption Identifier
        REF*P4 - Demonstration Project Identifier
        REF02 - Project Code
        REF*X4 - Clinical Laboratory Improvement Amendment (CLIA) Number
        REF02 - CLIA ID
        Loop 2310A - REFERRING PROVIDER NAME
        NM1*DN - Referring Provider Name
        NM103 - Referring Last Name
        NM104 - Referring First Name
        NM105 - Referring Middle Init
        NM108 - ID Code Qualifier
        NM109 - Referring Provider Identification #
        REF - Referring Provider Secondary Identification
        REF01 - Reference Identification Qualifier
        REF02 - Reference Identification
        Loop 2310B - RENDERING PROVIDER NAME
        NM1*82 - Rendering Provider Name
        NM1 - Rendering Provider Name, Tax ID and Provider ID#
        NM103 - Rendering Provider Last Name
        NM108 - Rendering Provider ID Type
        NM109 - Rendering Provider ID
        PRV*PE - Rendering Provider Specialty Information
        PRV03 - Rendering Provider Taxonomy Code
        REF - Rendering Provider Secondary Identification
        REF02 - Reference Identification
        Loop 2310C - SERVICE FACILITY LOCATION
        N3 - Service Facility Location Address
        N301 - Facility Address 1
        N4 - Service Facility Location City, State, ZIP Code
        N401 - Facility City
        N402 - Facility State
        N403 - Facility Zip
        NM1*77 - Service Facility Location
        NM101 - Facility Name
        NM103 - Facility Name
        NM108 - Facility ID# Qualifier
        NM109 - Facility ID#
        REF - Service Facility Location Secondary Identification
        REF01 - Reference ID Qualifier
        REF02 - Secondary Identifier
        Loop 2310D - SUPERVISING PROVIDER NAME
        NM1*DQ - Supervising Provider Name
        NM1 - Supervising Provider Name, Tax ID and Provider ID#
        NM103 - Supervising Provider Last Name
        NM108 - Supervising Provider ID Type
        NM108 - Supervising Provider Identifier Qualifier
        NM109 - Supervising Provider Identifier
        NM109 - Supervising Provider ID
        REF - Supervising Provider Secondary Identification
        REF02 - Reference Identification
        Loop 2320 - OTHER SUBSCRIBER INFORMATION
        AMT*B6 - Coordination of Benefits (COB) Allowed Amount
        AMT02 - Allowed Amount
        AMT*D - Coordination of Benefits (COB) Payer Paid Amount
        AMT02 - Payer Amount Paid
        CAS - Claim Level Adjustments
        CAS01 - Adj Group Code
        DMG - Subscriber Demographic Information
        DMG02 - Other Insured Birth Date
        DMG03 - Other Insured Gender Code
        MOA - Medicare Outpatient Adjudication Information
        MOA03 - Remark Code
        OI - Other Insurance Coverage Information
        OI03 - Assignment of Benefits
        OI04 - Patient Signature Source
        SBR - Other Subscriber Information
        SBR01 - Other Payer Responsibility Sequence #
        SBR02 - Patient Relationship to Insured
        SBR02 - Individual Relationship Code
        SBR03 - Other Insured Group or Policy Number
        SBR04 - Other Group Name
        SBR04 - Other Insured Group Name
        SBR05 - Other Insurance Type Code
        SBR09 - Other Claim Filing Indicator
        Loop 2330A - OTHER SUBSCRIBER NAME
        NM1*IL - Other Subscriber Name
        NM103 - Other Subscriber Name
        NM104 - Other Subscriber Name
        NM105 - Other Subscriber Name
        NM108 - Identification Code Qualifier
        NM109 - Other Subscriber ID Number
        Loop 2330B - OTHER PAYER NAME
        NM1*PR - Other Payer Name
        NM103 - Payer Name
        NM109 - Other Payer ID
        Loop 2330F - OTHER PAYER PURCHASED SERVICE PROVIDER
        NM1*QB - Other Payer Purchased Service Provider
        NM101 - Purchase Service Provider
        REF - Other Payer Purchased Service Provider Identification
        REF02 - Purchase Service Provider Identification
        Loop 2400 - SERVICE LINE
        AMT*AAE - Approved Amount
        AMT02 - Approved Amount
        CN1 - Contract Information
        CN101 - Contract Type Code
        CN102 - Monetary Amount
        CR5 - Home Oxygen Therapy Information
        CR501 - Certification Type Code
        CR502 - Treatment Period Count
        CR510 - Arterial Blood Gas Quantity
        CR511 - Oxygen Saturation Quantity
        CR512 - Oxygen Test Condition Code
        CR513 - Oxygen Test Finding Code
        CR514 - Oxygen Test Finding Code
        CR515 - Oxygen Test Finding Code
        CRC*70 - Hospice Employee Indicator
        CRC02 - Hospice Employee Indicator
        DTP*119 - Date - Oxygen Arterial Blood Gas Test
        DTP03 - Test Performed
        DTP*461 - Date - Last Certification
        DTP03 - Last Certification Date
        DTP*463 - Date - Begin Therapy
        DTP03 - Begin Therapy Date
        DTP*472 - Date - Service Date
        DTP03 - Date of Service
        DTP*480 - Date - Oxygen Arterial Blood Gas Test
        DTP03 - Arterial Blood Gas Test
        DTP*481 - Date - Oxygen Saturation Blood Gas Test
        DTP03 - Oxygen Saturation Test
        DTP*607 - Date - Certification Revision
        DTP03 - Cert Revision Date
        LX - Service Line
        LX01 - Line Counter
        NTE - Line Note
        NTE02 - Notes
        QTY - Anesthesia Modifying Units
        QTY01 - Anesthesia Quantity Qualifier
        QTY02 - Anesthesia Modifying Units
        REF*6R - Line Item Control Number
        REF02 - Line Item Control Number
        REF*G1 - Prior Authorization or Referral Number
        REF02 - Prior Authorization or Referral Number
        SV1 - Professional Service
        SV101 - Procedure Code
        SV101 - Procedure Code Modifiers
        SV102 - Line Charges
        SV104 - Units of Service
        SV105 - Place of Service
        SV107 - Diagnosis Code Line Number
        SV109 - Emergency Indicator
        SV111 - EPSDT Indicator
        SV112 - Family Planning Indicator
        Loop 2410 - DRUG IDENTIFICATION
        CTP - Drug Quantity
        CTP03 - Drug Unit Price
        CTP04 - National Drug Code Unit Count
        CTP05 - Unit or Basis of Measurement
        LIN - Drug Identification
        LIN03 - National Drug Code
        Loop 2420E - ORDERING PROVIDER NAME
        NM1*DK - Ordering Provider Name
        NM1 - Ordering Provider Name, Tax ID and Provider ID#
        NM103 - Ordering Provider Last Name
        NM108 - Ordering Provider ID Type
        NM109 - Ordering Provider ID
        REF - Ordering Provider Secondary Identification
        REF02 - Reference Identification
        Loop 2430 - LINE ADJUDICATION INFORMATION
        CAS - Line Adjustment
        CAS01 - Claim Adjustment Group Code
        CAS02 - Adjustment Reason Code
        CAS03 - Adjustment Amount
        SVD - Line Adjudication Information
        SVD01 - Other Payer Primary Identifier
        SVD02 - Service Line Paid Amount
        SVD03 - Procedure Identifier
        SVD05 - Quantity
        Loop 2440 - FORM IDENTIFICATION CODE
        FRM - Assigned Identification
        Loop 2310E - AMBULANCE PICK-UP LOCATION
        NM1*PW - Ambulance Pick-Up Location
        Loop 2310F - AMBULANCE DROP-OFF LOCATION
        NM1*45 - Ambulance Drop-Off Location
    
     
  • Robert Rambo

    Robert Rambo - 2013-03-07

    Please elaborate on the loop error
    What is the sub element etc

    Loop 1000A - SUBMITTER NAME
        NM1*41 - Submitter Name
        NM102 - Submitter Type Qualifier
        NM103 - Submitter Name
        NM109 - Submitter ID
        PER*IC - Submitter EDI Contact Information
        PER02 - Submitter Name
        PER03 - Submitter Contact Number Qualifier
        PER04 - Submitter Telephone Number
    
     
  • Robert Rambo

    Robert Rambo - 2013-03-07

    Hi bgregg

    Just want to Thank you for the link to the viewer im going to try it out today!

    -Rob

     
  • Sherwin Gaddis

    Sherwin Gaddis - 2013-03-08

    I just want to pop this back to the top.

    Any suggestions or insight on the question I asked about the NPI number not populating?

    Sherwin

     
  • Robert Rambo

    Robert Rambo - 2013-03-08

    Sherwin,

    As usual I went too far but I will use it as a personal ref for the future;

    // Summary
    $$$ X12 gen_x12 2310A not populating
    $$$ Userland = Patient/demographics/choices/*Referring Provider*! 
    $$$ Referrer =(Drop_List^)?; (PCP is referrer?);
    $$$ Renderer = (Drop_list); = fee sheet (Attending Physician)

    REM Is all of this set properly ^

    <
    Donna is talking about a loop 2310A?
    She may need to enter this on intake it should be set on a patient by patient basis if you have more than one PCP
    http://en.wikipedia.org/wiki/Primary_care_physician ?

    Try goto Userland Patient/demographics/choices/*Referring Provider*! 
    (Make sure this vale is assigned if you desire output > unassigned) <=>
    Fee sheet will give you rendering provider (drop down)
    I assume patients are getting referred by their primary always?

    ***There is also the medicare referrer is renderer (check box?) = I need to do more on this form_131
    <input type="checkbox" name="form_131" id="form_131" value="1"> admin/misc/medicare *refferer is renderer
        'MedicareReferrerIsRenderer' => array(
          xl('Medicare Referrer Is Renderer'),
          'bool',                           // data type
          '0',                              // default = true
          xl('For Medicare only, forces the referring provider to be the same as the rendering provider.')
        ),

    Since you have not customized the gen_x12 did any of your globals get replaced?
    I would do a diff on you /openemr/ before and after upgrade … since you have customized code,

    4.0.1 - 4.1.1(10) "Its not that complicated probally" maybe you can do this later tonight!
    diff
    https://github.com/openemr/openemr/commits/rel-410
    vs
    localhost/openemr.your.ver w/patches

    you probally already do a ftp compare?
    before upgrade / patch?
    >
    Its hard so steer from this side ;)
    Hope in the future we can make x12 easier and more open! 
    (
    I would like a dedicated sandbox for x12 testing
    It will require alot of coding, parsing, scrubbing, error reporting, tweaking
    We already have some error logging built in thanxs to Rod Roark @ sunset systems as you know
    I would like to see this expanded upon into full blown scrubbing GUI PHP/HTML/JS
    Brady, Rod are the goto's on this
    )
    Does this help?

     
  • Robert Rambo

    Robert Rambo - 2013-03-08

    got working on a x12 plugin for notepad++
    the output looks like this

    I want to add a side pane that includes comments on each loop
    Also all of the payer specifics as they change so we can put out a plugin update
    Anyone like this idea?


     
  • Sherwin Gaddis

    Sherwin Gaddis - 2013-03-09

    Robert,

    This part here that you said:

    Try goto Userland Patient/demographics/choices/*Referring Provider*! (Make sure this vale is assigned if you desire output > unassigned) <=> Fee sheet will give you rendering provider (drop down) I assume patients are getting referred by their primary always?
    

    Is not happening. I checked patient 2475 and the *Referring Provider* is left unassigned. It just hit me that I made a change to the Fee Sheet because they wanted the Referring Provider List to be pulled from the Address Book. Now I think this is where the discrepancy comes in at. So the rest of the code is still original and is looking to the User/Choices for the Referring Provider. But the Fee Sheet is not using that list it is using the Address book so the mod does not go deep enough to share with the billing to look to the address book and get the Referring Provider NPI.

    What do I need to change to have the billing gen_x12 look in the right place.

    In the Fee Sheet I changed (Brought over modification):
    Original Code:

    if (!$GLOBALS['ippf_specific']) {
      echo "&nbsp;&nbsp;" . xlt('Supervising') . "\n";
      genProviderSelect('SupervisorID', '-- '.xl("N/A").' --', $encounter_supid, $isBilled);
    }
    

    Modification:

            $query = "SELECT * from list_options where list_id = 'Modifiers' order by option_id ASC";
            $res = sqlStatement($query);
          echo "  <td class='billcell'>
                 <select name='bill[".attr($lino)."][mod]' " .
                 "value='" . attr($modifier) . "' " .
                 "title='" . xla("Multiple modifiers can be separated by colons or spaces, maximum of 4 (M1:M2:M3:M4)") . "' " .
                 "value='" . attr($modifier) . "' size='" . attr($code_types[$codetype]['mod']) . "'>
                 <option value=''></option>";
                            while($row = sqlFetchArray($res)){
                                $selected = ($row['option_id'] == $modifier) ? "selected='selected'" : '';
                                echo "<option value='".$row['option_id']."' ".$selected." >".$row['option_id']."</option>";
                            }
                 "</select>
                 </td>\n";
       
    //Builds a list of Rendering Physicians from the address book
    function genRefSelect($selname, $toptext, $default=0, $disabled=false) {
      $query = "SELECT id, lname, fname FROM users WHERE " .
        "authorized = 0 " .
        "AND username = '' " .
        "ORDER BY lname, fname";
      $res = sqlStatement($query);
      echo "   <select name='$selname'";
      if ($disabled) echo " disabled";
      echo ">\n";
      echo "    <option value=''>$toptext\n";
      while ($row = sqlFetchArray($res)) {
        $provid = $row['id'];
        echo "    <option value='$provid'";
        if ($provid == $default) echo " selected";
        echo ">" . $row['lname'] . ", " . $row['fname'] . "\n";
      }
      echo "   </select>\n";
    }
    if (!$GLOBALS['ippf_specific']) {
      echo "&nbsp;&nbsp;" . xlt('Referring') . "\n";
      genRefSelect('SupervisorID', '-- N/A --', $encounter_supid, $isBilled);
      #genProviderSelect('SupervisorID', '-- '.xl("N/A").' --', $encounter_supid, $isBilled);
    }
    

    Could this have thrown the billing system off?

    Sherwin
     

     
  • Robert Rambo

    Robert Rambo - 2013-03-10

    Is this so a limited user can enter what a su should enter?

     
  • Sherwin Gaddis

    Sherwin Gaddis - 2013-03-10

    No that is not the intent. The orginal was done by Visolve for us. I just kept it going. When we did the upgrade. I asked the billing person and she said she could have the modifiers either way.

    Is that what you are referring to?

     
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