bnpmunoz wrote on Thursday, April 26, 2012:
Hi I am currently attempting to export Medisoft Data and was wondering in which table are the patients linked to their insurance company. I exported MWPAT and got all the patients and the only thing that is remotely close to linking patient with insurance is the Patient ID #2 column but that doesnt really match up with the Insurance information from thw MWINS table. Any ideas? Or does anyone need clarification in the question?
rpl121 wrote on Thursday, April 26, 2012:
The table with insurance information is mwcas. Each patient (listed in mwpat table) can be linked to one or more cases with pertinent insurance information etc. You can create a join using the patient id, which is common to both. Then you need to figure out which case to use. You may decide on the one with the latest id number - the one most recently entered for that patient.
pfwilliams wrote on Monday, June 04, 2012:
Insurance data is maintained in Medisoft at the case level. Use to link MWPAT to MWCAS, then reference , and to get insurance codes. Those codes can be used against the
column when querying MWINS.
Am I reading this correctly, OpenEMR stores insurance data in the patient demographic record?
That can not be true, one needs to maintain history as a patient moves from one carrier to another... tell me I'm wrong!sunsetsystems wrote on Monday, June 04, 2012:
OpenEMR does maintain history of patient insurance over time, in the insurance_data table, though not at the case level. When a claim is generated the correct insurances are selected based on which was active on the date of service.
zhhealthcare wrote on Monday, June 04, 2012:
Glad that this topic is being brought up. We at ZH Healthcare believe that the insurance info has to be captured at the encounter level(I am assuming that is what is meant by “case level”) We are working on this issue for the benefit of the community whereby the insurance will be captured at teh encounter level by adding certain additional fields in the encounter table. This is also key to certain requirements of multiple primary insurance. The design is maintained is a way that there is least disruption. However the claims generation code will have to be changed to pick the insurance data from the encounter table than the current demo table.
Hope this can start the discussion on the pros and cons of this approach.
Regards
Sahmeem
tmccormi wrote on Monday, June 04, 2012:
Actually a CASE can span encounters, worker’s comp is a good example so are Mental Health treatment plans. There needs to be a way to create a new case and associate encounters, notes and other patient related data to that case (including insurance data). Insurance information, may in fact be case specific, that is it’s PRIMARY for a case but not for the general use in patient claim billing
-Tony
zhhealthcare wrote on Monday, June 04, 2012:
I had not considered case in the way Tony explained above. But I do feel that as a start we should work on the area of having multiple primary insurance covered and having the insurance info in each encounter. ZH Healthcare is undertaking to do this.
Is this acceptable to the community?
Shameem
sunsetsystems wrote on Monday, June 04, 2012:
Absolutely! But be sure to share some details of your planned approach for comments and suggestions before doing the coding. In particular I think it’s important to be able to select previously-entered insurance data where possible.
tmccormi wrote on Monday, June 04, 2012:
This Case issues/development needs to be a new thread. I wish we could just split this conversion out. But in anycase, Shameem, have your team post the concept and development model/plan in a new thread for discussion.
-Tony