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One day I will learn to investigate before posting. The issue was simpler than I could have imagined. The biller is new to using OpenEMR and she was not selecting the clearinghouse in the billing manager. So of course it was going to look wonki.
This is an outline of the loops & segments of the 837P 5010 format.
This webpage gives more details. It’s for the 4010 format but useful for about 95% of the 5010.
It’s very important that you have Availity help set up the X12 Partners dialog. If they can’t/won’t, it will be one gigantic headache.
Right off the bat, an obvious mistake with the second snippet is the P in the second line (just before the ~). It should be T if you are sending a test file.
If you get nowhere fast with the X12 Partners dialog setup & there are repeated rejections of the test file; consider using Office Ally instead. One of their representative will set it up for you via LogMeIn, making the entire process far smoother.
It’s far more complex than just clicking the clearinghouse in the Billing Manager. If Availity is not set up in the X12 Partners dialog to begin with, (see attached); there will be nothing to select in the Billing Module.
If that dialog is not set up properly, there will waves of rejections.
A particularly difficult sticky wicket is the ETIN box, see this.
See this for a sample X12 Partners setup for Availity.