2010AB loop being created by mistake


(Henry Alvarez) #1

Hello to all,

Just upgraded to 5.0.1-6 in Ubuntu 16.04 appliance. Having a new problem with X12 837 transmission to Availity. The Medicare Outpatient surgical claims only are being created with a 2010AB Loop. The 2010AB Loop should be created “(only if different than 2010AA billing Provider loop)” according to the OpenEMR 5.0.1 Users Guide/Version 5010 Wiki. Unable to find this Error in the forum. Able to work around this by correcting the batch manually. Anyone have any ideas as why this is happening?

Thank you,

Henry


(Stephen Waite) #2

hi @hamd, you can comment out this offending block, openemr/gen_x12_837.inc.php at rel-501 · openemr/openemr · GitHub


(Henry Alvarez) #3

Hi Stephen,

Do you “comment it out” by putting // to the left of every line?

On another subject with the same X12 file, the “Sender code is invalid” error for BCBS in Florida has been a perineal problem in the past. It has resurfaced again with 5.0.1-6. Has this been addressed in a different manner than individual hard code fixing like in the past. I tried my previous fix found bellow; But it didn’t work.

// Replace existing code with this code in your var/www/openemr/library/gen_x12_837.inc.php file.
// New code is between first and last lines which are shown here for location reference only.
// Use Notepad or Notepad++ for editing. The new code goes into Loop 1000A at line 140.
// Replace BCBS# with your Availity assigned number before pasting.

46";
}
if (trim($claim->x12gsreceiverid()) == ‘470819582’) { // if ECLAIMS EDI
$out .= "
” . $claim->clearingHouseETIN();
}else{
if ($claim->payerID()==‘00590’){
$out .= “" . “BCBS#”;
}else{
$out .= "
” . $claim->billingFacilityETIN();
}}
$out .= “~\n”;

Is there a problem with this fix now?

Thank you very much,

Henry


(Henry Alvarez) #4

Hi Stephen,

Looked it up (comment out). Yes this is an easy way workaround.
Can the above fix be used in gen_x12_837i.inc.php file ?

Thank you,

Henry


(Stephen Waite) #5

nice @hamd, yes, for 5.0.1 it’s in gen_x12_837.inc.php note no i after 837


(Henry Alvarez) #6

Hi Stephen,

Where would it go, because I tried it and it didn’t work.

Thank you,

Henry


(Henry Alvarez) #7

That’s why I thought it might go in the i file with the same name.

Henry


(Henry Alvarez) #8

Hi Stephen,
This is what was commented out. Just want to confirm that this was done correctly and it may be helpful to others that may be having the same problem.
Line 238 to 273.

// Pay-To Address defaults to billing provider and is no longer required in 5010 but may be useful

/* if ($claim->facilityStreet() != $claim->billingFacilityStreet()) {
++$edicount;
$billingFacilityName = substr($claim->billingFacilityName(), 0, 60);
$out .= “NM1” . // Loop 2010AB Pay-To Provider
" . “87” .
"
” . “2” .
" . $billingFacilityName .
"
” .
" .
"
” .
“*”;
if ($claim->billingFacilityNPI()) {
$out .= “XX” . $claim->billingFacilityNPI();
}
$out .= “~\n”;

    ++$edicount;
    $out .= "N3" .
        "*" . $claim->billingFacilityStreet() .
        "~\n";

    ++$edicount;
    $out .= "N4" .
        "*" . $claim->billingFacilityCity() .
        "*" . $claim->billingFacilityState() .
        "*" . stripZipCode($claim->billingFacilityZip()) .
        "~\n";

    if ($claim->billingFacilityNPI() && $claim->billingFacilityETIN()) {
        ++$edicount;
        $out .= "REF" .
            "*" . "EI" .
            "*" . $claim->billingFacilityETIN() .
            "~\n";
    }
} */

// Loop 2010AC Pay-To Plan Name omitted.  Includes:

Thank you,

Henry


(Jerry P) #9

If you’re planning to use this then it is still iffy. To give the conditional a fair chance convert both sides to lower or uppercase first. eg strtolower($claim->facilityStreet()).


(Henry Alvarez) #10

Hi Stephen and Jerry,

Tested and comment out worked great in removing loop 2010AB. By the way for some reason this was only causing a problem with out patient surgery patients not office claims.

The BCBS Sender ID was resolved by placing the code in the right place. This was my error. as the file had changed somewhat, I inadvertently placed it incorrectly. Just tried it and it worked like a charm. Will post it in the forum with updated Line # and slightly changed code noted for others who may have the same issue with BCBS Florida using Availity.

Out of curiosity, what is the purpose of the x12 file created by Jerry that has the i ?

I truly thank you for your help.

Henry


(Jerry P) #11

That is for folks that are billing using UB04 (CMS-1450). Mostly institutional out patient surgery or even home care. Can be turned on in Globals.