Error with eligibility check - Nothing returned from X12 Partner

Day-to-Day Users
1

I am trying to check eligibility for a patient but I am getting an error: “Nothing returned from X12 Partner.” I have the X12 Partners set up with Office Ally. I did a test claim upload and it is working; I can see the claim in the Office Ally portal.

For patient information, I have the first name, last name, date of birth, and gender. Insurance is selected with the policy number and relationship (self). For insurance, I have the name, state, country, payer ID, payer type (Other HCFA), and X12 partner (Office Ally).

Is there anything else I am missing to get the eligibility check working? I looked at the log but I’m not sure what to make of it. Appreciate your help.

Admin edit:
The solution is in v7.0.2(2). Recommend reading entire topic to get setup insight.
For those that want to fix by hand here is PR: Eligibility Fixes by sjpadgett · Pull Request #7774 · openemr/openemr · GitHub

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hi @moussa , do you have real time eligibility credentials from OA?

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I checked the same patient in Office Ally portal and I did get the coverage status.

4

Pretty sure you have to email realtime_support@officeally.com with your customer number asking for real time credentials.

Those go into the bottom section of the X12 partner setup in Admin->Practice Settings.

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Hi @stephenwaite , I reached out to OA and requested Realtime EDI Credentials which they gave them to me. From OA I have:
Username, Password, Sender ID (ISA06/GS02) [not the same as my tax ID EIN], Receiver ID (ISA08/GS03) [OFFALLY , which is diffferent than the one I used in my initial X12 setup 330897513] and two endpoint addresses:
• SOAP: rtx Service
• MIME: https://wsd.officeally.com/TransactionSite/realtime-request/MIME

I put the Username in Client ID, Password in Client Secret, I used both links but still getting error when checking eligibility .

Appreciate your thoughts

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I looked at this discussion and the pic attached, it seems the space does not accept enough cherecters and my User Logon and User Password are cut off

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oh, create a new x12 partner and then update the bottom of the insurance company with the eligibility x12 partner

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Yes, I did select OA for Eligibility check when creating the insurance.

Will OA username and password provided goes here (which only allow 10 cherecters)

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Or Here?

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In the top picture, and recent versions of OpenEMR allow for more than 10 characters.

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Hi @moussa
@stephenwaite asked if I could take a look at your issue so first, what version OpenEMR are you testing from?
Are you willing to upgrade to patch 2 if I need to make changes?
And lastly I will need your test credentials and test patient so I can test to debug.

Otherwise the best I can do is review current OA spec to see if my module is current. I find it highly doubtful api URL has changed as it is a SOAP plus companies are very hesitant to change api schemas for legacy but we’ll see.

So please reply asap because I won’t be on this very long.

11

Thank you for looking at this. I believe I took my openEMR from here OpenEMR 7.0.0 Linux Installation - OpenEMR Project Wiki

Here is my system specs:
CMS Version : 0.7.2.6-Phoenix
PHP Version: 8.2.24
PHP safe_mode: Off
PHP safe_mode_gid: Off
OS: Linux openemr 6.1.0-26-cloud-amd64 #1 SMP PREEMPT_DYNAMIC Debian 6.1.112-1 (2024-09-30) x86_64|
WebServer: Apache/2.4.62 (Debian)

Are you willing to upgrade to patch 2 if I need to make changes?
Yes

And lastly I will need your test credentials and test patient so I can test to debug.
Sure.

12

Great and thanks for getting back so quickly. I’m reviewing current code and spec now.
If you could email me all the x12 partner credentials plus a screenshot and I’ll need an insurance company, patient and whatever else.
sjpadgett@gmail.com or PM me here.

2 Likes
13

I pretty much knew the answer that the X12 segment ISA-02 and ISA-04 max length is 10 characters. Looking at spec verified.
One reason for this is that the entire length for ISA segment is fixed at 106.

So if OA is forcing these longer passwords and usernames then they violate X12.

@moussa Check with OA realtime support and have them justify or I thought OA allowed user to set these. Either way so I can test and debug to spec, please have new credentials issued following the 10 character limits.
Please report back here OA response or outcome for others to learn.
Thanks

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hi @sjpadgett , since it’s a separate x12 partner could you co-opt one of the other x12 partner fields as a work around?

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Maybe but would require a new input to avoid confusion.
Still in this case trying to fix in v7.0.0 is problematic.
I also believe the response has changed and I need to verify parsing.
But if OA insist they won’t cooperate because ISA-02 04 isn’t required then I have no choice.

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right, it’s not required because you’re sending it in the mime not in the 270 payload?

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Right. I finally found my archived test messages from 2019 so I can see past responses.
But you’re right and I’ll see what I can come up with however I hoped to not have to mess with the username and password for the v7.0.0 folks.
@moussa Can you do an About to verify your version?

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18

So Though OA sends back a success error code in mime they report transaction X12 error in returned X12 message. ~MSG*INVALID OFFICE ALLY PAYER ID SUBMITTED IN 2100A NM109~ I don’t parse for this and then report to user so needs to be fixed.
I have a older Payer list but it doesn’t have Caresource OH only Caresource KY
@moussa Are you sure that Payer Id 31114 is correct?

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Thank you @sjpadgett and @stephenwaite for looking into this.

I have two Payer IDs for CareSource: 31114 and 31500. I used them both in different patients in OA and they go through.

Can you try 31500 for the patient that I shared with you.

1 Like