I am constantly being asked to build features into the program. The latest feature added is a module for Claims Management. People ask me all the time Has anyone done … My reply every time is “I don’t know because people won’t share what they have done”. I try to post everything I’ve built when I can. This is one of those I can. This is for Trizetto, but it will work for any clearinghouse because the file format is all the same, as it is standardized.
Suppose you are interested in supporting this module build. PM me.
@stephenwaite This is to connect to any clearinghouse and be able to work the claims from within Open is the goal. Essentially trying to bring the clearinghouse data into Open
@stephenwaite does the program have a process for the 277CA file? I am talking with Trizetto. I know the system can generate a 270, but that is for eligibility.
The challenge that I am running into is that every clearinghouse names the file differently. The content may be the same but the location and name of the file will change with every clearinghouse.
I ended up building the claim management system for Ensora.
This is what the dashboard looks like.
The goal is to make it so that claims can be managed from here without having to log into Ensora.
This module looks very useful! I am interested in using it, but I don’t see anything about it on Modules. Is there any documentation for this module (features, screenshots, etc) you would be able to point me to for this module @juggernautsei ?
Huge thanks for any assistance and for all you do (and have done) for the community!
Sorry, I have been buried in development. This module is not a public module. I in the process of developing it for those who will be using Ensora as a clearinghouse. The Dashboard & Timely Filing can work without the ensora account. I have tried it in multiple client sites and it works across the board. PM me and we can talk more.
Ah, that makes sense. We use ClaimRev for our clearinghouse so it seems like this might not be directly applicable. That being said, if you ever post a YouTube video demo I would be interested, if only for inspiration. Thanks!
Today I reached a new milestone, The ERAs are auto posting. There is more work in the UI to do but the auto posting of remits was a huge hurdle to cross for me. Thought I would share a screenshot. The goal is to not have to use the Ensora interface. Once ERA is finished. Then we will finish the eligibility
It was great today when the biller was talking with me on the phone going over the attributes of the system. She was looking in the timely filing and saw the notice a claim had not been filled. She didn’t know that was there and looked into it and was able to see why the claim had not been filed. She fixed the issue in under a minute and filed the claim.
