New Clearinghouse - ClaimRemedi - requires changes to 837 generation

OpenEMR Development
#1

We’re using ClaimRemedi for a new provider and they are rejecting claims.

The main problem I’m seeing is the NM1, N3 and N4 lines basically being blank at the service level.

LX1~
SV1HC:99204:25375.00UN11:2:3:4~
DTP472D820181115~
NM1DK*1~
N3~
N4~

This happens because the “billingProvider” is blank because nothing is filled in the Billing Options Form.

In claim it assumes a default box17Qualifier of ‘DK’… I think the default box17Qualifier should be null indicating nothing is being specified or perhaps there is another upstream check to indicate that no Billing Options are specified like billing_options is null?

public function box17Qualifier()
{
    //If no box qualifier specified use "DK" for ordering provider
    //someday might make mbo form the place to set referring instead of demographics under choices
    return empty($this->billing_options['provider_qualifier_code']) ? 'DK' :
        $this->billing_options['provider_qualifier_code'];
}

I would like to make the changes in a way the community will accept (a new concept for me!) so wanted to check in and get some suggestions.

Also - should I enter these as issues and bypass the forum?

Thanks,
Kyle

#2

Hi Kyle,

Issue on with line number 788 below code /var/www/html/openemr/library/billing/src/X12_5010_837P.php, function is not called correctly.

#3

hi @KyleNave, thanks for the bug report, you could default to '' instead of ‘DK’

see openemr/CONTRIBUTING.md at master · openemr/openemr · GitHub for how to submit a PR

#4

That works for me. I’ll make the change and submit a PR today.
Thanks,
K

1 Like
#5

We are having an issue with this.
At claim level with no address info the ordering provider needs to be in the claim. Oklahoma Medicaid wants the city state zip too.
Where should I look for this? I will build a PR.

Untitled
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#6

Here is the PR that adds Ordering Provider to the 837. This won’t make patch 1 for v7.0.2. If you need this prior to next patch release or version release. You can grab the code from this PR and apply it.

1 Like
#7

@stephenwaite was already working on this. I did not know or search for a PR before posting mine own.