Eligibility Checks & Clearinghouses


(Stephen Waite) #121

ever worked with care evolve? will start another thread for this if needed, guess you’re looking for an actual lab not an interface build


(Jerry P) #122

Nope, I was thinking Quest/LabCorp. is care evolve nationwide?


(Jerry P) #123

Add new button for update of eligibility from Insurance->Eligibility tab.


and success

502 PR new feature by sjpadgett · Pull Request #2286 · openemr/openemr · GitHub
501 PR back port of 502 eligibility feature PR #2276 by sjpadgett · Pull Request #2279 · openemr/openemr · GitHub


(Jerry P) #124

Finally a full 501 patch. Hope I got it right this time and i’m done with this feature unless some of you test and find something. OA been hammered but batch upload/parse, not so much.

patch: removed see below.

Good luck :slight_smile:


(Stephen Waite) #125

will test soon, thank you @sjpadgett


(Kevin Mc Cormick) #126

I get periodic OpenEMR updates from this forum, but I missed this topic. On the EDI history parsing code tor the 270/271 files, I am wondering if anyone has tried to view a 271 file in the EDI History file viewer. I was hoping some of that code would get more usage, but I guess if it is not known, it won’t get used. There is the edih_x12file_class.php file which should be able to read and parse any health care EDI file and provide a table of envelopes and transactions. There is also a file to read and display a 270/271 file. It has been a while, but I am willing to try to explain the methodology if it is helpful.


(Jerry P) #127

I’ve looked at it cursory and just wish i’d known about it from the start of integrating realtime interface. It has everything needed and is well done. I’ll use it more fully when I convert edi.php to a class.
Thanks for the module.

btw: I only found one code that I couldn’t find on lookup. I believe it is EB03 96.


(Jerry P) #128

Update: Add eligibility x12 partner and payer id to Practice Insurance.
New full patch: eligibility-501-final-patch.zip (555.5 KB)
and insurance:
ins


(Kevin Mc Cormick) #129

One esoteric point you may want to address is the BHT claim ID in the /library/billing/src/X12_5010_837P.php file, line 78. I think this is where the edit would go. At one time I had an edit to put a concatenation of the ISA identifier and the ST number (e.g.‘1234567890002’) instead of ‘0123’ as the reference identifier. This unique number is required to be returned in BHT03 claim status, but not necessarily in eligibility, and will allow exact identification of the submission instead of the multiple matches possible with the CLM01 identifier. If a claim is submitted twice, the ‘pid’ identifier in CLM01 will still be the same. It still bugs me.


(Stephen Waite) #130

hi @kevmccor, thanks for the suggestion, it could go here, openemr/billing_process.php at master · openemr/openemr · GitHub and use the global from the ISA, openemr/billing_process.php at master · openemr/openemr · GitHub


(Kevin Mc Cormick) #131

I think you have identified the correct insertion point. Here is an attempt at the code:

if ($elems[0] == 'BHT') {
  $bat_content .= substr_replace($seg, '*'.$bat_icn.$bat_stcount.'*',  strpos($seg,  '*0123*'), 6);
  continue;
}

(Stephen Waite) #132

this tests ok, add bht claim id per kevmccor by stephenwaite · Pull Request #2317 · openemr/openemr · GitHub