HIPPAA 5010 x12 compliance

aethelwulffe wrote on Thursday, December 23, 2010:

837 changes:
https://www.cms.gov/ElectronicBillingEDITrans/Downloads/ProfessionalClaim4010A1to5010.pdf
835 changes in same downloads location.

The current x12 export code has some serious issues already, as it is not fully configurable, and even has some output format errors.
  What is in the works for the 5010 standard?

I am going to try to map out changes that will be necessary for 5010, as well as for table changes needed to include or exclude data for the new format.  I will also attempt to make changes (or at least map out code needs if I am unable to code them properly) to the header data interface code in the x-12 partner GUI to allow for full configuration, and base output configuration by version choice.
  Puhleez advise me who and where someone is working on this stuff for 4.0, and if there are any resources/patches anyone has made for this data in 3.2.0

sunsetsystems wrote on Thursday, December 23, 2010:

I have a client who wants it by July, so quite possible I’ll do it for them if nobody else wants it sooner.

Yeah 837p is missing some things here and there.  But it’s a lot better than the old logic that required FreeB and SQL-Ledger.  What happens is that clinics are only willing to sponsor the parts they need, so the little-used features are sometimes a surprise when they are needed.

Rod
www.sunsetsystems.com

aethelwulffe wrote on Friday, December 24, 2010:

Ah, good to know that this is 837p and not 837i.  I wasn’t absolutley sure based on the version statement in the partner setup.  Seems like if it puts out only one format, it should have the version hard-wired yes?  Otherwise a listbox…
  Seems like it is beyond Openemr to export to ValueOptions (FHC &Affilliates)  First, they require data in ISA01-04.  Next they actually want to know how many claims and what the total billing in a batch is as a “security feature” or “validation” of some kind, and you don’t really get a report out of the billing module for this sort of thing like you do with EZClaims or Medisoft (Both of which I still hate BTW).

sunsetsystems wrote on Thursday, May 05, 2011:

Hey, anyone want to help sponsor this by contributing a 5010 837p Implementation Guide?  Looks like those are $525 from http://store.x12.org/ .  Quite a ripoff considering it’s a government mandated standard….

Rod
www.sunsetsystems.com

aethelwulffe wrote on Friday, May 06, 2011:

http://portal.flmmis.com/FLPublic/Portals/0/StaticContent/Public/COMPANION%20GUIDES/FLMMIS_5010_837P_Companion_Guide_v1-1.pdf
FAQ’s
http://portal.flmmis.com/FLPublic/Provider_EDI/Provider_EDI_SubmissionInformation/tabId/66/Default.aspx
Pertinent CFR 46 162

aethelwulffe wrote on Friday, May 06, 2011:

Hey, Rod, I am perfectly willing to have a quick go at this.  I am pretty sure I can handle it.  I have gotten *rather* familiar with those bits of the EMR here of late.  I can at least make functional changes that do that job, and submit for hot wash-up.
  I happen to have needed almost everything that anyone else ignored.  Makes me uniquely qualified (if under-educated).

sunsetsystems wrote on Friday, May 06, 2011:

Already got some Companion Guides… need the Implementation Guide which is the official spec and is not free.  It’s no good if you’re arguing with a payer or clearinghouse and can’t reference or quote from the spec.

If you wanna help that’s great but I’ll be in there too.  Oh and the 835’s will also need attention.

Rod
www.sunsetsystems.com

aethelwulffe wrote on Friday, May 06, 2011:

I’ll work on getting the damn implementation guide.  I’ll get funding from the agency to buy it if I can’t shake down a…um…copy somewhere.
  POC to whine about this bunch of bs…  hazeline.roulac@cms.hhs gov or 410-786-1173  I’m sending a mail tonight and calling her in the morning.

aethelwulffe wrote on Friday, May 06, 2011:

P.S.  and I am writing my congressman.

aethelwulffe wrote on Friday, May 06, 2011:

OK, these ppl suck.
  We (Adoption Related Services of PInellas) are gonna make our tangible contribution to OpenEMR by sending these pirates their DaneGeld and getting a copy of the implementation guide.  I gotta get a-hold of Linda (if she will answer her damn phone) and get approval.  Our take this year has been about 150% of the planned budget (the EMR has really helped tremendously) so even though it is over our $500 without board approval discretionary single-item limit, she should approve it with no problem.  Getting the whole suite of edi formats to properly process with a standardized edition of OEMR, including our need for more header info as well as getting 270/271 to work should be well worth them coughing up a tiny wee bit of cash.

tmccormi wrote on Friday, May 06, 2011:

Art
  This would be good, if these guides are in digital format and you donate them to OEMR we would be able to make them available to members (which Rod is).  The other option is for you to donate the money to OEMR and we buty the specs in the name of the 501©(3)  there may even be special pricing for non-profits.  This is the whole reason that OEMR exists …
-Tony
OEMR Board

aethelwulffe wrote on Friday, May 06, 2011:

Well, we ARE a 501©(3), but the immediate hang-up is the $25 over our $500 single purchase limit.  Linda has to get board approval via an e-mail vote, and that may take a couple of days.  If someone is cool with popping for the other 25 bucks, we can just donate the $500.  I hate when people create their own red tape.  It really would be best if OpenEMR buys them ultimately, just in case there is whining about copyright bullshit (in this case, it IS bullshit, this publication should be public domain).  Tonight is Med Management night (when our ARNP comes in), so Linda (executive director) will be busy until late late late, so we will bide on this until 10PM or so, or perhaps in the morning.
  I suppose we should just hit the donate button on the main web-site Ja?  I’m trying to find it, but I keep getting time-outs on the browser….
  I myself am a total churchmouse.  Anyone got $25?

tmccormi wrote on Friday, May 06, 2011:

I think OEMR could afford the overage with out a problem… 
The main site donate buttonn is kind of broken right now.  I’ll get the OEMR donate access up over the weekend and announce it or you can mail a check to OEMR (see http://wiki.oemr.org/wiki/OEMRFundraising for address)
-Tony

sunsetsystems wrote on Friday, May 06, 2011:

Guys, thanks for your assistance with this!

Rod
www.sunsetsystems.com

tmccormi wrote on Friday, May 06, 2011:

You are welcome Rod, I still use the hard bound copy of X12 003050 that I paid $425 for in 1995 ….
-Tony

aethelwulffe wrote on Saturday, May 07, 2011:

Check?  What’s a “check”?….Oh Yeah!  I remember those.  It would probably be better to get the donate button up anywho?  Ja?

tmccormi wrote on Saturday, May 07, 2011:

Paypal account has been created, you can donate directly using paypal and the email address “treasurer _@_ oemr.org

I’ll hopefully I’ll get the links up this weekend, I wrote the code a while back, but for some reason I can’t find it… sigh.

-Tony

aethelwulffe wrote on Monday, May 09, 2011:

Otay,
The BOD for ARSP has the budget request for e-mail vote.
  I hope they go with the simple “donate” option.  Either way, when I drafted the letter, I made sure that they understood that funding this is NOT really an option…  :slight_smile:
  Won’t be long now.

aethelwulffe wrote on Thursday, May 12, 2011:

Okie MacPokie,

$500 check is on it’s way to Tony.  I didn’t get asked how it was wanted, they just handed me a check….Technoramuses.

jcahn2 wrote on Friday, May 13, 2011:

Thanks Art!   You’re the cat’s meow!             Jack