Claim number, Workers Compensation

docw wrote on Tuesday, August 18, 2015:

I’m switching over to OpenEMR after limping along with a MS-Access/VBA system I started building in the previous millenium.

I provide care under Workers Compensation and by contract for other services.

Workers Compensation is entirely centered on Claims. A Claim will have a series of visits. A claim must have an employer, insurance company, Date of Injury, and a claim number associated with it. I haven’t found a provision in OpenEMR to set this up.

It appears I can put a claim number or case number in the demographics section, but it won’t be linked to a particular set of visits. Layout Based Visit forms don’t seem to provide a way to associate persistent data with a series of visits.

On a related topic, the above information ultimately must be assembled into very specific state-defined and elaborate forms/reports. I’m trying to come up with a seamless window into the data. Are there any readers who have ideas on how to approach this? I’m new to PHP and MySQL, but looking to learn if necessary.

fsgl wrote on Tuesday, August 18, 2015:

When we submit Workers Compensation claims, we send a copy of the CMS 1500 to the local comp board & the insurer. The C-05 form, specialized for Ophthalmology, must also be submitted to the insurer.

Getting the data into the Patient Summary or Fee Sheet is not the hard part. Creating the C-05 is. The LBV Form is designed for clinical notes mainly, not for billing.

You will need to create a similar php file along the lines of the gen_hcfa_1500.inc.php & configure the Billing Manager to print it up. No small feat for a PHP neophyte.

If there is an unlimited amount of time to spend on this project, then it can be DIY. If time is at a premium, it would make sense to pay for help.

fsgl wrote on Tuesday, August 18, 2015:

The T option in LBV can be used for static text such as the presenting history, which would not change from one claim to the next.

4.2.0 comes pre-loaded with it, therefore it’s not necessary to add the comit.

teryhill wrote on Tuesday, August 18, 2015:

    A = 'Age'
    B = 'Gestational Age'
    C = 'Capitalize'
    D ='Dup Check'
    G ='Graphable'
    L ='Lab Order'
    N ='New Patient Form'
    O ='Order Processor'
    P ='Default to previous value'
    R ='Distributor'
    T ='Description is default text'
    U ='Capitalize all'
    V ='Vendor'
    0 ='Read Only'
    1 ='Write Once'
    2 ='Billing Code Descriptions'

They have changed to these

docw wrote on Tuesday, August 18, 2015:

At this point, I’m still trying to determine if I can make Open EMR work for me. The Case Number/Claim issue is really the focus of my concern. If I can see where the necessary data can go, I can then consider form design. It’s not other billing forms I need, but visit reports in a certain format. And I do remember the unlimited amount of time it took me to create my current version of those reports in Access, so your suggestion of hiring the work is well taken.

fsgl wrote on Tuesday, August 18, 2015:

In our state we are not required to send in the C-05 on a pre-printed form, unlike the requirement for using the CMS 1500.

If this holds true for your state as well, I think that the Templates module can be adapted for the comp forms. You’re right; they don’t need to be coupled to the Billing Manager.

The scanned comp form can be the template while the Case Number can be one of the variables (fields). A tutorial on how to edit the scanned .pdf. It’s unclear from the Wiki article which .php file to edit to add variables such as Case Number. Very easy to add it to Patient Summary, but not so obvious in the relevant Templates file.

It would be the equivalent of the IRS forms, taxpayers fill out online, save & file.

fsgl wrote on Tuesday, August 18, 2015:

Try adding Case Number as a new field in the Demographics layout & insert {Case Number} in the appropriate place in the Template. Editing of the .php file may not be necessary.

Attachments to be found in the 4.2.0 Demo.

docw wrote on Wednesday, August 19, 2015:

This will provide a work-around, so long as a person does not have two claims open simultaneously. Ideally, there would be a one-to-many relationship between patient and claims, with a one-to-many relationship of claim to visits.

docw wrote on Wednesday, August 19, 2015:

I am not finding the T option will carry the entries from one visit to the next. I’m not clear what is meant by “Description” in this context. The history and claim number would not change from one VISIT to the next, but a new history and new claim number will be needed for another injury case in future. Thank you for your assistance on this and other matters today, it’s been very helpful.

teryhill wrote on Wednesday, August 19, 2015:

Use the “P” option for that

docw wrote on Wednesday, August 19, 2015:

When I add a new field in this fashion, must I keep track so I can recreate the change after updates to OpenEMR? Or, would the data and table structure carry over?

fsgl wrote on Wednesday, August 19, 2015:

There is no reason why there cannot be more than one case number in Demographics or any other variables for that matter. If you need a memory aide to keep them straight, a new category can be created in Issues (Administration/Lists/IssuesTypes) & it will show up on the right.

No carryover. Upgrade involves copying certain old sites folders, such as Documents, over new & then upgrading. Always a good idea to backup everything or create a system image in case of a catastrophe.

fsgl wrote on Wednesday, August 19, 2015:

Found the old thread but yet to digest all the steps about creating a static text. Description is the reservoir for the text.

Or you can use the P option as suggested by Terry. There are some old threads about that as well.

Will have an in-depth look later.

fsgl wrote on Wednesday, August 19, 2015:

Thanks, Terry.

Pimm’s article updated.

yehster wrote on Wednesday, August 19, 2015:

The statement that there is “No Carryover” is incorrect…

Adding a field to the demographics form makes a change in the MySQL database, to both the database schema (in the patient_data table) and the data rows (in the layouts table.)

Those changes will still be present after an upgrade.

A proper backup/system image is still a good idea, of course.

fsgl wrote on Wednesday, August 19, 2015:

Was referring to sites folder, not database.

yehster wrote on Wednesday, August 19, 2015:

The original question about carry over was about “adding a field” which has no impact on the sites folder.

Also the recommended method for patching is to extract new files on top of the old, rather than copying old files on top of a new install.

fsgl wrote on Wednesday, August 19, 2015:

Old thread about P option & CAMOS.

It may be helpful to attach comp forms to understand the requirements.

Buidlng the forms for the clinical notes should be fairly easy. Far greater challenge with the comp forms, but Templates should get the job done.

To make things worse is the inability to submit claims electronically. At least that is the situation locally.

fsgl wrote on Wednesday, August 19, 2015:

Upgrade guide for Windows & Linux instructs copy & replace with old sites folders, not extract & insert.

If variables are added to the Templates; then the Documents folder will need to replace the new Documents, which is devoid of data, during an upgrade.

Patching is a different process from upgrading.