Billing multiple days of service

hi @ncavalier no, it needs separate encounters currently

Thank you!!

You’re welcome @ncavalier. Will be a nice feature that I’d like to contribute.

Hi @stephenwaite, are there plans to have this feature added to the next update? I dropped back to paper claims for various reasons, and it’s a waste of trees not to be able to have multiple dates of service on one CMS-1500 form.


hi @vrjula, sure, we can probably fix both problems you’re having, let’s work on the electronic first for the :deciduous_tree: s!

can you post any electronic errors or describe why you dropped to paper please? thank you

Sure @stephenwaite. It’s not a matter of electronic errors with OpenEMR. It’s just that I no longer participate in any insurance networks. As such, I only file claims on behalf of inpatients I’ve seen in the hospital setting, which occurs in batches. I also want to steer clear of HIPAA, a stance explained well by @sourdoughpablo here: Problems with diagnostic pointers on HCFA-1500. Hence my falling back to sending paper claims. I’m willing to pay the price of delayed payment, which inevitably happens as compared to electronic claims.


ok, it’s actually pretty involved since the hcfa function was simply built for 1 claim per encounter and the remodel would have to sort through all of the items in the billing manager and then see if those encounters could be on the same claim form

same pid
same service facility
same billing provider
same referring provider
same accident date and accident type if appropriate
and then sort the items by date of service and create a new claim if greater than 6 items

Yes, I was afraid that was the case! At least we can use pre-printed HCFA forms, so I don’t have to go out and buy stacks of forms made for the dot-matrix era (they still have tractor feed holes)!


Hi @stephenwaite Has this feature been worked on? I am considering a migration to open-emr but the ability to bill for multiple DOS’s is the roadblock for me. My example- we see the same patient 3 times per week for physical therapy. I would like to be able to send one hcfa claim instead of 3 at the end of the week.

hi @es-hpm, the hcfa still needs work. Can you bill this electronically with an 837?

Unfortunately I cannot. I deal with workers comp and no-fault carriers and they do not accept 837’s for these claims… I wish they would. I send out thousands of claims per week on paper.

ok @es-hpm, some clearinghouses have entered into agreements with these carriers but have you thought about faxing the claims?

@stephenwaite we do over 2,000 claims per day with 2-5 pages of notes attached. I don’t think there is a fax machine that can keep up with that volume. Besides, getting the claims out consolidated is one reason but it also has to do with inbound correspondence. One patient seen 3 times per week means 3 claims out but it also means 3 checks in, and or 3 EOB’s, delay’s, denials, etc. I could cut down my paper usage by 1/3rd, on average.

hi, I mean you could fax the claims electronically so they never would be “printed” and with the notes attached too. There’s an option under admin->globals->billing that “Prints the CMS 1500 on the Preprinted form”.

True but it doesn’t solve my 3:1 paper in problem. Do you know of a dev/team that might want to work on this project? or is it just too big, that’s why no one has done this yet?

It’s a combination of things and even lack of interest since paper is on a steady decline. The carriers will soon have to support EFT and ERA in addition to 837 to keep up with HIPAA mandates.

@stephenwaite OK. Thank you very much for your thoughts. I really appreciate them.

I guess stage one for a project to create claims across visits/DOS would start with re-purposing feesheet into a claim builder where a lookup is provided to add encounters to sheet via some filtering for selection order. POS would not be restrictive however billing location may. This would involve a new invoice numbering scheme and certainly some billing table changes. Good news is that most of existing billing code could be reused with the posting and reconciliation becoming the most difficult.
Another difficulty is supporting what would become a legacy feature for existing compatibility with previous billing.
easy peasy, right :slight_smile:

@sjpadgett ,
Definitely easy. Prob take several months of normal human effort. But just 2 days of @sjpadgett effort :smile:

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Hmm, sounds like my ego is being stroked some to take this on. May have worked. :slight_smile:
I think I will do the claim builder which will give a much better idea of the claim generation side of this and allow me to pick on some billing tables.
I think my approach will be having a master claim set based on a new invoice id scheme. Then allow visit/encounters from a selection of available where each, on selection, becomes a subset to claim master using same claim identifiers we are use to ie. 30-99.
Billing manager will then be modified to parse new claim scheme. Once done this far will open new PR to test and run continued development.
Being I’ve used up one day, I suppose this is due tomorrow.

Advise and recommendations always welcome.