juggernautsei wrote on Thursday, November 19, 2015:
Dr H does procedures that Demi have to bill the same CPT code multiple times ~ 64636, 64636, 64636 ~ but the system has decided to make it go to the insurance companies as once billed and change the units ~ 64636 X 3 ~ In order for Dr H to get paid by the insurance companies the system cannot take it upon itself to change what Demi create to bill out!
How can we fix this?
fsgl wrote on Thursday, November 19, 2015:
Code change required.
tmccormi wrote on Thursday, November 19, 2015:
Billing gets more an more complicated every day … these kinds of things should be either global options, or in many cases Payor specific options.
fsgl wrote on Friday, November 20, 2015:
Which makes us all (patients & physicians) long for the good old days when we needed only Major Medical & Major Surgical for hospitalizations.
juggernautsei wrote on Friday, November 27, 2015:
After checking the pages that you have posted above, I have come to the conclusion that the locations you showed are where changes would have to be made not the changes that are needed. Right?
fsgl wrote on Friday, November 27, 2015:
The attachments give you a general idea where the code changes are needed.
Not knowing how, I did not offer a solution.
juggernautsei wrote on Friday, November 27, 2015:
Thanks you kindly for your pointer. It is of great help.
juggernautsei wrote on Friday, November 27, 2015:
From another biller to concure with what you are saying
“she has a legitimate issue. Some insurance companies will not process claim for payment if charges aren’t listed on 3 separate lines AND some require it to be on 1 line x3 units. Biller must have the option to choose which way to bill it as per insurance co protocol.”
This is a deep issue and I have to “learn” this section of the program to be able to begin to address it.
Has anyone in the development community addressed this issue yet?
juggernautsei wrote on Friday, November 27, 2015:
Starting to peal back the layers on this issue. If there is a Units box with a default of 1. Why doesn’t it work if the units are changed to 3?
fsgl wrote on Friday, November 27, 2015:
You’re welcome.
This problem had been discussed previously, but at that point no developer participated in the thread; therefore I’m under the assumption there has been no remedy in the codebase.
I get the sense that Line 68 from 2.png & Lines 970-971 from 3.png add up the procedure counts of identical CPT’s to give just one line in Box 24 with a multiple of Units in Box 24G.
Your task is to provide a mechanism to have both the tally & the option not to have it.
I did not test if deletion of Lines 970-971 would eliminate the tally in the 837P, but it would be a starting point.
juggernautsei wrote on Monday, November 30, 2015:
Follow the modifications that are outlined in the screenshot.
Comment out the section shown.
This does not need to be a global feature.
If not comfortable with editing code, replace with the file from git hub.
fsgl wrote on Monday, November 30, 2015:
Quick work, thanks.
Not all users will be comfortable commenting out the section.
From your original post, there are times when a tally is required while at other times not. A setting in Globals would give the user either option.
tmccormi wrote on Tuesday, December 01, 2015:
I wonder what those “times” would be? are they per claim? per payor? per provider (rendering or billing)? or per clinic/installation instance?
That would determine where the selection should be, ultimately, placed.
fsgl wrote on Tuesday, December 01, 2015:
Determinant: insurers.
tmccormi wrote on Tuesday, December 01, 2015:
Which means that this should be an option in the Payor / insurance company table, not globals.
fsgl wrote on Wednesday, December 02, 2015:
We don’t need this feature. Sherwin seems content commenting/uncommenting.
If you want to write codes for Insurance, be my guest.
juggernautsei wrote on Thursday, December 03, 2015:
But see what we are over looking is that the program will already accept a tally entry so if the biller enters CODE x3. The form will have CODE x3 print out.
The only thing commenting out that consolidation part of the code did was stop it from combining single line entres. Nothing else changes so from my point of view the manual entry decided by the biller’s knowledge of which times, which claims and which insurers.
fsgl wrote on Thursday, December 03, 2015:
Thanks for the clarification.
There still be some users whose knees go wobbly when told to change a code.
For those users it would be considerate to have another mechanism instead of uncommenting.
juggernautsei wrote on Tuesday, December 08, 2015:
Tony,
since the code works for the construct. There is no additional coding needed. I have tested the system and if the billing person puts 3 in the units the system will show that code for a unit of 3. If the inusurer don’t like it that way then the biller simply enters a line for each code being billed and the system cranks it out that way. All is satisfied. My mom told me to KISS.
And my programming mentor told me to always do the simplest thing that works.
This works.
tmccormi wrote on Wednesday, December 09, 2015:
That sounds sensible.