All my claims are being rejected. I need your help please.
I spoke to Availity. They state that they are receiving an “VX” value in the “Payer ID Qualifier - NM108.” This is incorrect and all my claims are being rejected. They state that they should be getting the value of “PI.”
Can someone please help me identify where things went awry and I how I can fix this. Very important, please and thank you.
Looks like a misguided change was made on May 28. Talking about this in library/gen_x12_837.inc.php:
// The 5010 spec says:
// "On or after the mandated implementation date for the HIPAA
// National Plan Identifier (National Plan ID), XV must be sent.
// Prior to the mandated implementation date and prior to any phase-
// in period identified by Federal regulation, PI must be sent."
// *************** Anybody know what that date is? ***************
// August 2011 - Publish interim final rule
// October 1, 2012-March 31, 2013 - Enumeration
// April 1, 2013-September 30, 2013 - Testing
// October 1, 2013 - Implementation
"*XV" .
Someone changed that PI to XV and judging from the comments, that should not happen until next year. So change it back to PI.
Perhaps some date-testing logic would be even better. Can someone confirm the 10/1/2013 date?
OK - this has not been tested yet
Open C:\xampp\htdocs\openemr\library\gen_x12_837.inc.php
in line 349 you will find the PI to change to XV
Thanks Rod of www.sunsetsystems.com
You can use a free editor like Notepad++, something you will use from time to time with OpenEMR
the search function makes this change a quick and easy task
After correcting some other errors X12 to Availity seems to be working.
Receiver ID Qualifier (ISA07) set for Duns( Dun &
Sender ID (ISA06) AV09311993
Receiver ID (ISA08) 030240928
Application Sender Code AV01101957
Submitter EDI Access Number 030240928
Sender ID Qualifier (ISA05) Mutually Defined