robertrambo wrote on Friday, March 08, 2013:
robertrambo wrote on Friday, March 08, 2013:
got working on a x12 plugin for notepad++
the output looks like this
I want to add a side pane that includes comments on each loop
Also all of the payer specifics as they change so we can put out a plugin update
Anyone like this idea?
juggernautsei wrote on Saturday, March 09, 2013:
Robert,
This part here that you said:
Try goto Userland Patient/demographics/choices/*Referring Provider*! (Make sure this vale is assigned if you desire output > unassigned) <=> Fee sheet will give you rendering provider (drop down) I assume patients are getting referred by their primary always?
Is not happening. I checked patient 2475 and the *Referring Provider* is left unassigned. It just hit me that I made a change to the Fee Sheet because they wanted the Referring Provider List to be pulled from the Address Book. Now I think this is where the discrepancy comes in at. So the rest of the code is still original and is looking to the User/Choices for the Referring Provider. But the Fee Sheet is not using that list it is using the Address book so the mod does not go deep enough to share with the billing to look to the address book and get the Referring Provider NPI.
What do I need to change to have the billing gen_x12 look in the right place.
In the Fee Sheet I changed (Brought over modification):
Original Code:
if (!$GLOBALS['ippf_specific']) {
echo " " . xlt('Supervising') . "\n";
genProviderSelect('SupervisorID', '-- '.xl("N/A").' --', $encounter_supid, $isBilled);
}
Modification:
$query = "SELECT * from list_options where list_id = 'Modifiers' order by option_id ASC";
$res = sqlStatement($query);
echo " <td class='billcell'>
<select name='bill[".attr($lino)."][mod]' " .
"value='" . attr($modifier) . "' " .
"title='" . xla("Multiple modifiers can be separated by colons or spaces, maximum of 4 (M1:M2:M3:M4)") . "' " .
"value='" . attr($modifier) . "' size='" . attr($code_types[$codetype]['mod']) . "'>
<option value=''></option>";
while($row = sqlFetchArray($res)){
$selected = ($row['option_id'] == $modifier) ? "selected='selected'" : '';
echo "<option value='".$row['option_id']."' ".$selected." >".$row['option_id']."</option>";
}
"</select>
</td>\n";
//Builds a list of Rendering Physicians from the address book
function genRefSelect($selname, $toptext, $default=0, $disabled=false) {
$query = "SELECT id, lname, fname FROM users WHERE " .
"authorized = 0 " .
"AND username = '' " .
"ORDER BY lname, fname";
$res = sqlStatement($query);
echo " <select name='$selname'";
if ($disabled) echo " disabled";
echo ">\n";
echo " <option value=''>$toptext\n";
while ($row = sqlFetchArray($res)) {
$provid = $row['id'];
echo " <option value='$provid'";
if ($provid == $default) echo " selected";
echo ">" . $row['lname'] . ", " . $row['fname'] . "\n";
}
echo " </select>\n";
}
if (!$GLOBALS['ippf_specific']) {
echo " " . xlt('Referring') . "\n";
genRefSelect('SupervisorID', '-- N/A --', $encounter_supid, $isBilled);
#genProviderSelect('SupervisorID', '-- '.xl("N/A").' --', $encounter_supid, $isBilled);
}
Could this have thrown the billing system off?
Sherwin
robertrambo wrote on Sunday, March 10, 2013:
Is this so a limited user can enter what a su should enter?
juggernautsei wrote on Sunday, March 10, 2013:
No that is not the intent. The orginal was done by Visolve for us. I just kept it going. When we did the upgrade. I asked the billing person and she said she could have the modifiers either way.
Is that what you are referring to?
juggernautsei wrote on Sunday, March 10, 2013:
after thought, would the above code be better with line numbers and file name?
juggernautsei wrote on Monday, March 11, 2013:
Hi Rob,
are you referring to the select statement?
Where do you suggest passing the value?
Thanks Rod
on a side note, read your site bio page, impressive
robertrambo wrote on Monday, March 11, 2013:
Hi Sherwin,
You know the answer to this!
<?
If referrer <unassigned> it does not come out:
$sql = “SELECT * FROM users WHERE id = ‘$referrer_id’”;
function referrerLastName() {
return x12clean(trim($this->referrer));
}
if ($claim->referrerLastName()) {
$out .= “NM1” . // Loop 2310A Referring Provider
?>
But like I said above that Rod is the author and pro on this
IMHO a genius so might wanna ask him for some help, id buy him a coffee!
Im here to contribute not for support.
Basically im just a bumbling idiot! lol
Good luck on cheapemr
-Rob
robertrambo wrote on Monday, March 11, 2013:
BTW Rod where do I send that StarBucks gift card, you have a donate page?
robertrambo wrote on Monday, March 11, 2013:
bumbling *mumbling 
juggernautsei wrote on Tuesday, March 12, 2013:
Rob,
my apologies, my dyslexia kicked in and I saw Rod and not Rob.
I was reading between the lines and could follow the hint you were getting at.
However, I did come across a small coding error and I corrected that first to see if it was throwing off the code before going to do major coding like you suggested. I am still just a babe in the woods of this coding stuff. I still have not grasped the concepts of OOP in PHP. I have not had a teacher or lesson at this point. I am still just working on the basics. Thanks for your patience’s and answers. I will report back after Donna tries the billing again.
Sherwin
robertrambo wrote on Tuesday, March 12, 2013:
Hi Sherwin,
No worries just trying to point out that
He is much more qualified for the job than I am!
Fee sheet might look something like this before save
<select name="ref_providerID">
<option value="">-- Please Select --
</option><option value="Unassigned">
I do see the need for this in the code and run it past Rod
Maybe you can get it added to the code it makes referrer choice much easier from fee sheet
Hope this helps my friend
-Robrobertrambo wrote on Tuesday, March 12, 2013:
Make sure your sql upgrade went off ok ? ref_providerID inserted ? patient table
juggernautsei wrote on Thursday, March 14, 2013:
Rob,
I don’t have a ref_providerID column in the patient data table. I have referrer and referrerID and providerID.
please contact me at sgaddis at jse dot net.
Regards,
Sherwin
juggernautsei wrote on Tuesday, March 19, 2013:
Rob,
The system does not function right for the doctors office that is a cardiologist and may impact others as well.
Rob explained that if the patient demographics is blank that the system looks to the fee sheet. This is not good practice. Please read below:
This is from Donna that does the billing:
" I confirmed with the last batch of claims that the referring doctor on the claims is still pulling doctors name from the referring provider listed in demographics, not the name listed on the fee sheet. 5 of these claims from the last batch had to be manually corrected in payerpath & re-filed. The major concern is with those claims that have invalid data but don't reject & are forwarded to the insurance anyway. For example: PID 355. Demographics > Choices > Referring provider shows KATHLEEN MCENTEE which is what was listed on claim for 3/4 EKG. This should have been Dr East on the claim because he was the one who ordered the EKG. So this claim went to insurance with incorrect data. This claim didn't get rejected because data was in the referring provider field...eventhough it was the incorrect data...payerpath system has no way to tell if the data is accurate, only if it is present. "
Can this be added to the code base if we make this change so that we don’t have to carry it by ourselves?
Has anyone fixed this already?
Sherwin
juggernautsei wrote on Tuesday, March 19, 2013:
After thought…
Can anyone tell me where the code is located to point the fee sheet if the patient demographics in not populated?
Trying to save some time of hunting it down.
Sherwin
robertrambo wrote on Tuesday, April 02, 2013:
Hi Sherwin,
I wanted to put the time in to get the ref_providerID into the fee sheet and away from the demo sheet where it seems a little hidden. If this gets done I would like to see the code included in a release. I wondered if the patient demo is unassigned and the fee sheet is assigned what hits the sql db “4” ? null? I was thinking that the patient demo part of the code needs to go away and start fresh on the fee sheet?
-Rob
robertrambo wrote on Tuesday, April 02, 2013:
Hello
CMS put out 16 edits earlier this month that may or may not affect your claims
Keep an eye on your claim rejections closely if you are unsure if you will be affected!
Changes effective April 1st 2013.
-Rob
juggernautsei wrote on Tuesday, April 02, 2013:
Hello Rob,
I have been putting out other fires but this one is back on the burner again. I looked for a week and tried to decipher where the code was looking but I did not find it as of yet. Right now they are going through and taking the referring physician out of the patient demographics and the billing person is having to verify each claim manually and they are not happy.
So, this week I am picking it backup and hope that with fresh eyes after being away for a while I can get it corrected.
I would like for everyone to see the coding we have done but unfortunately for me, i can’t get the github to push the code out to the site. I will keep working on that also.
Where do I find the edits that CMS put out?
Sherwin