But Availity, my clearinghouse, rejects the file stating that the "2" is an "Invalid code value". The "2" is the value stored in the $HLSubscriber variable.
What possible values can be used at that position.
Has anyone (I am sure lots of you have) successfully created an X12 file and submitted a claim where the insured was different from the patient?
If so, if you don’t mind, can you please post the part of the file started with HL*3 all the way up to the next ~ as in HL*3*2*23*0~. This alone would help me a lot with the troubleshooting and no private data are being passed through this line.
As I stated above, my clearinghouse is having problems with the 2.
I purposely changed the 2 to a 1 (just for troubleshooting) to make the line HL*3*1*23*0, and resubmitted the claim. It accepted it, but then it said the 23 was wrong.
The problem with these clearinghouses, they tell you it’s wrong, but they don’t give you a list of acceptable values.
HL is the segment, what comes after the 1st asterisk is position one, would be described as HL01, after the 2nd asterisk is position two, described HL02.
I do a google search with the following key words: HL02 x12 837
That’s how I came accross the following paragraph in the following page:
Note: If the subscriber is not the same as the patient, Loop 2000C must be used for the patient information. If the subscriber is the same as the patient, Loop 2000C is not sent.
HL01 AN 1/12 Must begin with 1 for the first HL01 in the transaction and be incremented by 1 each time an HL is used within the transaction. Only numeric values are allowed in HL01. The same value should also be reported in every subordinate Patient Hierarchical Level HL02.
HL02 AN 1/12 Must contain the same value as the parent Service Provider Hierarchical Level HL01
HL03 ID 1/2 Must equal "22"
HL04 ID 1/1 Must equal "0" or "1"
I have sent succesfully claims where the patient is a dependent. I use gen_x12_837.inc.php from openemr2.8.3, however I do not have any of those segments readily available.
Check the patient demographics, be sure the pt relationship to subscriber is selected corrected, and the subscriber info is filled in correctly.
It has helped very much. It definitely pointed me in the right direction.
The HL*3*2*23*0 was correct. What was incorrect was HL*2*1*22*0~. It needed to be HL*2*1*22*1~. So I ended up changing the initial value of this variable $PatientHL from 0 to 1.
I am not sure if this is a bug, but it worked for me.
That site is an excellent site as it explains the different fields and the different loops.