Eligibility Response not parsing into table

juggernautsei · September 1, 2017, 1:29pm

We have sent out and received an eligibility response from Florida Medicaid. When the file is imported, the system says that the import was successful but when we check the patient’s chart. The response does not show. I checked the response table and there is no data in the eligibility_response table or the eligibility_verfication table.

We are using v5.0.0, MariaDB, Linux OS

Is there a patch of fix for this?

brady.miller · September 2, 2017, 8:18am

Any errors in the php log by chance?

juggernautsei · September 2, 2017, 11:41am

I just ran the file again and there are no error messages. The system seems to create the proper request. The response import code does not match what is in the response file so the import cannot happen.

I found this sample 271 eligibility response file.

stephenwaite · September 2, 2017, 5:15pm

this value is usually `~

github.com

openemr/openemr/blob/33ef407f6364a6eb1f75d7b0172708f84775dd25/interface/reports/edi_271.php#L66


$i          =   0;
$j          =   0;
$patientId  = "";


// Loop through each line
foreach ($Response271 as $Value) {
   // In the array store this line
    // with values delimited by ^ (tilt)
    // as separate array values


    $DataSegment271[$i] = explode("^", $Value);




    if (count($DataSegment271[$i])<6) {
            $messageEDI = true;
            $message = "";
        if (file_exists($target)) {
            unlink($target);
        }
    } else {
        foreach ($DataSegment271[$i] as $datastrings) {

stephenwaite · September 4, 2017, 9:38pm

hi @juggernautsei , please see this simple fix to segment delimiter by stephenwaite · Pull Request #1066 · openemr/openemr · GitHub

juggernautsei · September 6, 2017, 6:21pm

Thanks for the simple fix. I will pass it along to the EU.

amireltaweel · August 28, 2018, 6:53pm

hi Brady,

I’m trying to snd batch to ClaimMD. the request batch pulls patient’s SSN as patient ID and puts has the Payer ID as “CLAIMMD” not the ins company’s CMS ID.

how do i fix that?

Thank you

stephenwaite · August 29, 2018, 2:50pm

hi @amireltaweel, do you have claimd’s specs for the 270/271? thank you

ps it looks like you’ll probably want this

github.com

openemr/openemr/blob/rel-501/interface/reports/edi_270.php#L96


								   p.sex,
								   p.pid,
								   p.pubpid,
								   i.policy_number,
								   i.provider as payer_id,
								   i.subscriber_relationship,
								   i.subscriber_lname,
								   i.subscriber_fname,
								   i.subscriber_mname,
								   DATE_FORMAT(i.subscriber_dob, '%%m/%%d/%%Y') as subscriber_dob,
								   i.subscriber_ss,
								   i.subscriber_sex,
								   DATE_FORMAT(i.date,'%%Y%%m%%d') as date,
								   d.lname as provider_lname,
								   d.fname as provider_fname,
								   d.npi as provider_npi,
								   d.upin as provider_pin,
								   f.federal_ein as federal_ein,
								   f.facility_npi as facility_npi,
								   f.name as facility_name,
								   c.name as payer_name

to be changed from i.subscriber_ss to i.policy_number