hitechelp wrote on Monday, April 30, 2012:
Does anyone know where insurance eligibility information can be edited or entered?
I’ve looked everywhere I could think of, but no joy.
Everything listed under the eligibility tab is showing “n/a”
The “Edit” button next to Insurance brings up the Primary, Secondary and Tertiary tabs, but no Eligibility tab.
hitechelp wrote on Monday, April 30, 2012:
Forum search revealed an answer, (sort of)
Does anyone know if this is functional yet?
aethelwulffe wrote on Tuesday, May 01, 2012:
(unqualified answer)
Cannot confirm that it ever worked. Can confirm that it does not work. Can also confirm that it was never complete to the point needed for basic functionality for more than a small fraction of users.
hitechelp wrote on Wednesday, May 02, 2012:
That is sad news. Is anyone out there who may be part of that small fraction using this successfully, able or willing to point me in the right direction?
tmccormi wrote on Wednesday, May 02, 2012:
The Eligibility interface worked in X12 270/271 version 4010 format and depended on sending a batch to the clearing house and processing the downloaded reply batch. The company that produced it fell off the OpenEMR project before 5010 was required. At this point no one has offered to fund the update to make it work with 5010, and so it has not gotten any priority.
Most people just use the web access with their clearing house of choice to do that and update the effective date in the insurance tab, so it doesn’t seem be much of an issue or any more work than processing a daily batch request.
Direct, by patient, look ups of Eligibility are pretty dependent on where you are connecting to, that may be why no generic direct look up interfaces have been contributed to date.
Tony
www.mi-squared.com / @tonymi2
oemr.org / @OEMR_org
hitechelp wrote on Friday, May 04, 2012:
Thanks Tony,
I really appreciate your informative response.
We were hoping to avoid any 3rd party interlopers.
Should we be able to fund such a project, could you give us a rough estimate the cost?
tmccormi wrote on Friday, May 04, 2012:
Frankly I don’t think there would be too much to do to get it up to spec. And, actually, I would recommend Sunset Systems for this, if Rod has the bandwidth. The OEMR can provide the official specs for 270/271 v5010 to any developer that takes it on. Contact me off list at tony ‘at’ mi-squared.com if you want us to do a formal quote.
Tony
www.mi-squared.com / @tonymi2
oemr.org / @OEMR_org
sunsetsystems wrote on Friday, May 04, 2012:
Tony, thanks for the kind words. As things stand now I’ll have some time in about two weeks if there is still interest then.
kevmccor wrote on Friday, May 11, 2012:
I have a lot of “hack” x12 code at github.com in my edihistory project (which I am going to delete and re-post). I personally use it all the time and I wrote a 271 parse script, but I have nothing to test with, so I just ‘believe’ that it would work. BTW, the jquery dataTables would be a good interface because the eligibility categories could be grouped and the thing could be compact. The eligibility response can have a lot of items in it, so the view should really be per patient. Also, since the response file is uploaded, database entries, if any, only need to identify the file and the relevant part. The /interface/reports/edi_270.php and /library/edi.inc scripts in OpenEMR look like a beginning, but there are variables initiated in one script and used in the other, so it is confusing. I think the $compEleSep variable is used where the $segTer belongs. I generated a file and I doubt any clearinghouse would accept it, but most of the stuff is there.