Medicare Rejected CMS 1500

ideaman911 wrote on Tuesday, July 07, 2009:

We have recently been getting NGS Medicare rejects of CMS 1500 forms as missing the date in the SOF in field 31.  Their own code says it is not needed since we HAVE a signature on file with its date, but they still insist.  We have asked why it seems to not occur elsewhere, for which they have no answer except THEY want it.

If you have the same problem, replace the 32a section of …/library/gen_hcfa_1500.inc.php with:

// 31. Form Date:                                           Added Date Printed 7/5/09 for Medicare returns PIA JCH
    $formdate = "          ";      
    if ($ct === ‘MB’) { 
          $formdate = date(‘Y-m-d’);
    }   

  // 32a. Service Facility NPI
  put_hcfa(61, 12, 22, $formdate . ’  ’ . $claim->facilityNPI());  // inserted $formdate & space 7/5/09  JCH

which will print the current date beneath the "Signature On File" in box 31

Joe Holzer    Idea Man
http://www.holzerent.com

sraj49 wrote on Thursday, February 11, 2010:

Hi Joe,

The same probelm here also. They need the date to be filled in at field 12 and 31. The date of preperation of the claim has to appear in both 12 and 31 but does not. I tried your solution for field 31 but it does not work. Any refined solution?

Thanks

Raj

ideaman911 wrote on Friday, February 12, 2010:

Raj et al:

OK, the first problem is that SF formats to a single space between characters.  You need TEN blanks between the quote marks (") in the first $formdate definition, not one.

The field fix for 31 is actually relocating start and size of 32A which is the NPI for the service facility due to a quirk in the ezpdf.php file which you need not even look at.  So either 10 spaces or a date will print in advance of the NPI on that line.  But the spaces have to be there.

The same logic could be used for Field 12, and you could even use the same $formdate as the variable.  You must use the same 10 space or date definitions, but since they have room to be on the same line, you  merely have to separate them.  A twelve space between the quotes as in the Field 32 "$formdate and $claim->facilityNPI() variables must be made, and the resultant put_hcfa statement must show with locator attributes as 29, 7, 39 to properly allocate the printing space.  Use the same MB definer for the contingency as only Medicare has this deviation (of course - since THEY promulgate it!), and ONLY if you get pushback from YOUR Medicare processor.

Joe Holzer    Idea Man    315-622-9241     im@holzerent.com  or  joe.im0602x@gmail.com
http://www.holzerent.com  or  http://www.EMRofCNY.com

ideaman911 wrote on Friday, February 12, 2010:

If anyone wants a copy of the correctly formatted, which will print the date for both the 12 and 31 fields only when Medicare B is selected, contact me directly and I’ll send you a copy.  You can see from that how simple it is to change for others on contingencies.  The file is …/library/gen_hcfa_1500.inc.php  and I can send you the 3.1 version (3.2 may be identical, I simply have not yet checked).

Joe Holzer    Idea Man    315-622-9241     im@holzerent.com  or  joe.im0602x@gmail.com
http://www.holzerent.com  or  http://www.EMRofCNY.com

anonymous wrote on Thursday, March 04, 2010:

For medicare claims a lot of the boxes are no longer needed. In the gen_hcfa_1500.inc.php file there are notations which state what is no longer needed as well. I haven’t found a switch for that in the globals.php so I am just placeing “//” to omit the boxes. I believe in future releases this should be done already since on medicare’s manual (http://www.cms.hhs.gov/manuals/downloads/clm104c26.pdf) they explicitly state this.