Ncpdp

Management and Administration
1

csmith0503 wrote on Wednesday, October 19, 2016:

I am in the middle of trying to impliment the Universal Claims form listed below:
PUCF-D01PT (VER 1.1)

I have had a difficult time doing so. I am following all the documentation on developing forms and I think I have that part under control. Basically these are preprinted forms. I just need to take the patients data and print it or “overlay it” over the preprinted forms. I am not finding alot of documentation on out put in the system though. Can you guys give me a heads up or a look in the right direction?

A sample of the form can be found at :
https://www.asbaces.com/NEWACES/(S(52uwywmy15pcnpaqtffgisax))/storefront.aspx?CatalogID=4909&CatalogIndex=0&CategoryID=9453&CategoryIndex=0&PageNumber=1&SavedCart=N

Thank you!

2

teryhill wrote on Wednesday, October 19, 2016:

Curtis I would suggest looking at openemr\library\gen_hcfa_1500.inc.php . This is the file that is used to print the HCFA’s. I created forms for Texas medicaid and the UB04 form and this was my starting point.

HTH

Terry

3

csmith0503 wrote on Thursday, October 20, 2016:

Taking a look now. Thank you for your reply.

4

teryhill wrote on Thursday, October 20, 2016:

Let me know when and if you get stuck and I will try to help. terry@lillysystems.com