Need add Policy for Subscrib when not Pt self

Management and Administration
1

cpbdman wrote on Monday, December 06, 2010:

Problem: Some payers (esp BCSB) have an ‘01’ for policyholder aka subscriber and ‘02’, ‘03’ etc for family on policy. Problem is there is no entry blank under Subscriber policy in default v3.2. I can enter name, relationship to pt, DOB, addy etc but just need one more blank- for ID so that I can have ID xxxxxxxx02 for pt and xxxxxxx01 for subscriber.

So I thought an easy fix, go to Admin and add a option (done easily to add Jr/Sr in ‘Who’). But when I go to Admin, layouts, Demographics- I get who, contacts, employer, etc… but then no insurance section! So where do I go to change the Insurance Demographics layout? Then also if I add an option for Policy Number under Subscriber, will that convey to X12?

Again, what I need to do is for BCBS claims be able to generate X12 that has one number for Pt Policy and a different Policy for Subscriber (when not ‘self’). Now I have to upload X12 (we use Zirmed), and very quickly grab claim and edit - changing pt policy number to xxx……02 from the xxx….01. Sometimes may not catch before it goes to payer- and a pain anyway.

Any help is GREATLY appreciated.

2

tmccormi wrote on Monday, December 06, 2010:

Sadly the insurance section has not be ported to the layout model yet.  So changes to that have to be made in actual PHP code.  In this case demographics_full.php, as I recall.    Rod’s the expert on that process.

There is more to it though, if you add a field, then it needs to be added to the sql tables and all that entails, and, since it needs to be supplied to the insurance company, then the programs that produce claims need to use the new fields and put the values in the right places.  library files Claim.class.php,  gen_hcfa_1500.inc.php, gen_x12_837.inc.php are likely to be involved.

-Tony