harrisonr wrote on Wednesday, February 22, 2012:
Most faciltiy data is input, and displayed w/ no affect on processing logic. How do these facility settings affect processing? Billing Location check box? Accepts Assignment check box? Primary Business Entity check box? POS code selected (facility type) ? For example, does OpenEMR treat POS #21 InPatient and #22 OutPatient any different? Or POS #53 Mental Health Center?
yehster wrote on Wednesday, February 22, 2012:
I can’t provide a complete picture of what all the various functions do.
However, I can tell you that the POS code get used when generating an X12 claim. At a minimum the POS type gets reported in the Loop 2300 section of a claim.
There is also some simple logic which treats home visits and hospital visits differently when generating claims.
Those other check boxes affect whether you can choose specific facilities on the fee sheet/during billing processing.
aethelwulffe wrote on Wednesday, February 22, 2012:
Facility data does not affect processing logic much, except in the case where billing location code is a hospital (21 inpatient) in which it uses the date of onset/hospitalization date. Facilities that are marked a BILLING LOCATIONS, and are selected properly for “Billing Location” in the encounter form will provide the group NPI, billing contact, billing location, EIN and if there is an “Accept assignment” set to automatically adjust off payments to that facility for differences in remittances vs. billing rate. and a couple of other things. Facilities that are merely location codes are used in the encounter forms box “Facility”. This facility provides the location code for the service. In cms1500 terms, billing facility is your “Primary business entity”.
Do you happen to know if there are any quid-pro-quo’s associated with POS 53 (Mental Health Facility)? Is that an inpatient setting that should be dealt with the same as POS21?
Anywho, I am pretty sure I can answer any questions you may have about what affects what as far as 837 electronic claim output. HCFA I am not really familiar with, as only 1:1000+++ of our claims are paper.