5010 and ERA upload

jenjhall wrote on Monday, January 30, 2012:

Hi, I just tried to upload an ERA file that was in the new 5010 format.  Has this ability been updated for the 5010 format yet?

aethelwulffe wrote on Monday, January 30, 2012:

We may not get it to an official patch as quickly, but I hope to have a file to parse 835 by Wednesday night.  I just got the “real” documentation for doing it.  With the help of others, we should get this taken care of quickly.  Hang onto your files and your seat for just a wee bit more.  Sorry this was not taken care of earlier.

tmccormi wrote on Monday, January 30, 2012:

I’ve got some live files / claims to test with a my customers …  Let me know as soon as you need some QA…
-Tony

aethelwulffe wrote on Tuesday, January 31, 2012:

http://www.oemr.org/phpBB3/viewtopic.php?f=10&t=49&p=320#p320

For testing (ya, ya, I know all about that GIT thingy) you can refer to the post linked above and download what seems to be a working parse_era.inc.php file.  I forgot to add a test file to it, but I will pop that on now.
There is more to this issue, and this is only round 0.1 (sparring really), but I wanted to get some input on my amateur starting point.
No promises.  I’ll start swearing on stuff later as I test it against actual existing claims in a real database.  There are a couple of fields I need to check and compare for even for this basic stuff.
  I decided to go for the basic functionality, even though I have been kinda laying out groundwork and snooping into code to develop the “full story” of processing payments. 

jperrien wrote on Saturday, February 04, 2012:

Pardon my ignorance but is there a place in openemr to enter a referring doctor and his upin number.  This is required on the hcfa 1500 form.

aethelwulffe wrote on Saturday, February 04, 2012:

Referring doctors are often entered as users, or in the address book, just not authorized.
Look also for the encounter form “Admin\Miscellaneous HCFA options”, near the fee sheet.  This is assuming your install is 4.x+

yehster wrote on Saturday, February 04, 2012:

There actually isn’t anything on the vanilla Misc HCFA Options for referring provider. (Box 17) .

The place that this gets specified (which is non-intuitive and thus understandably confusing) is on the patient’s demographics page.

On demographics, under tab “Choices” there is a field Provider (which you might think is the person at your facility who this patient sees most of the time).  However, this field is where the HCFA form gets the referring provider information.

aethelwulffe wrote on Saturday, February 04, 2012:

Doh!  Sorry about that.  I really must remember to log into a standard test version before I answer any “simple” questions like that.
Demographics is of course a decent spot to set a referring provider, but should probably be in a section named “providers” or something like that.  Setting and re-naming the providers properly would be a big help, and also enable new ACL checks to restrict providers to their own patients in searches, viewing, etc…  This would be a real help that would not be hard to implement.  The field should be named properly, and of course, along with all the other billing options set and/or displayed in the fee sheet, would be a great benefit.

juggernautsei wrote on Saturday, February 04, 2012:

Hi,
(Hope that I am not out in left field)…
I have been reading this thread for a while and now it is nearing an area of concern for my client Dr East. He had us do a modification that we have been carrying for year now. The mod involved adding a date of service to. Here is a question from the billing person regarding the dates of an encounter and being able to bill for multiple days on one encounter.

<il>
"  “When your patient’s illness onset date is the same as the date you rendered service, then enter only the date of service in the field indicated. Leave the onset date field blank. Entering the same date in both the Onset field and Service field will cause an error for claims being sent to 5010-enabled payers.”  Sherwin, we use the Onset field as the Admit Date field (which now will populate in block 18 of CMS1500 form).  Date entered in both of these fields are often the same, so how are we to avoid the “error” of hopital claims???  Do I have to start entering Hospital Admission Date in the “Misc Billing Options for HCFA-1500” section in order to avoid this “error”???

Also, does this mean that 5010 will not allow a date range…meaning can DATE OF SERVICE (FROM) & DATE OF SERVICE (TO) be 2 different dates to allow us to bill for 2 or more days on 1 encounter??  For example:
1/1/2012 - 1/3/2012 billed for 99232 x 3 units"
</il>

Rod fixed it for us the last time when we upgraded to version 4.0 and i was able to migrate it to the 4.1. Can the from date be added to the grub so that it is apart of the base code?

Sherwin