New CMS 1500 form by October

physmed wrote on Thursday, August 03, 2006:

I was just going over the changes that have been proposed for the new CMS 1500 claim form this morning.  All of a sudden it dawned on me what is going to happen to our claim billing in OPENEMR?  Because the form template in FreeB is based on the current CMS 1500 form.

sunsetsystems wrote on Thursday, August 03, 2006:

This would be a matter of changing freeb/formatbin/hcfa.pl to use the new format.  Are the differences extensive?

Rod
www.sunsetsystems.com

physmed wrote on Thursday, August 03, 2006:

According to the claim form change log that I have there are 44 changes that have been proposed for the current form.  These mostly deal with the implementation of the National Provider Identifier number.

physmed wrote on Thursday, August 03, 2006:

Also I forgot to list the site where you can take a look at the current test version.  It is www.nucc.org/images/stories/PDF/1500_claim_form.PDF

michael_barnett wrote on Friday, August 04, 2006:

Fortunatly i was just starting the area of the form where the changes are.

I will have my version finished by aug 22nd.

about the freeb version…

Does it fill out the form completely? i do not see where all the information is collected and have had to make many changes to the encounter form to collect the information required.

since all but 3 of the changes are within box 24 it should not be hard to modify what i already have.

AS soon as i finish it i will submit it for approval and usage.

The way i am building it it will be able to pull from the database all the information needed or you can fill it out manually and print it.

here is the time line
Modified Transition Timeline

The NUCC has made modifications to its recommended timeline for transitioning to the revised 1500 Claim Form. The timeline is now:

    * October 1, 2006
      Health plans, clearinghouses, and other information support vendors should be ready to handle and accept the revised (08/05) 1500 Claim Form.

    * October 1, 2006 - March 31, 2007
      Providers can use either the current (12/90) version or the revised (08/05) version of the 1500 Claim Form.

    * April 1, 2007
      The current (12/90) version of the 1500 Claim Form is discontinued; only the revised (08/05) form is to be used. All rebilling of claims should use the revised (08/05) form from this date forward, even though earlier submissions may have been on the current (12/90) 1500 Claim Form.

The NUCC strongly recommends that providers contact their health plans and/or clearinghouses/vendors prior to submitting a claim on the revised form to ensure that they are prepared to accept the revised form.

sunsetsystems wrote on Saturday, August 05, 2006:

FreeB seems to fill it out well enough to elicit payment.  :slight_smile:

What exactly do you find to be missing?

Rod
www.sunsetsystems.com

michael_barnett wrote on Saturday, August 05, 2006:

well i have not had freeb fill one out but i do not see where the following information is collected.

box 8 employment or student
box 10 related to employment auto or other state if auto
box 16 dates unable to work
box 20 outside lab
box 22 medicade resubmissioncode original ref
box 23 prior auth number
box 19 local use
box 24 b (place of service) c EMG  h EPSDT family plan
box 27 accept assignment

I’m not saying freeb does not have the capability to answer these boxes but i cannot see where the program illicits the information nor stores it.

sunsetsystems wrote on Saturday, August 05, 2006:

Some of these are implemented, some not.  What you should do is look in freeb/formatbin/hcfa.pl to find the function calls for them, and then look in openemr/library/freeb/ for the corresponding RPC function definitions.

For most or all of the unimplemented items, there are stubs in the function definitions where you can plug in your code to get them from the database.

Hope this helps.

Rod
www.sunsetsystems.com

tekknogenius wrote on Thursday, November 09, 2006:

Has anyone started on this yet? If not I’ll start taking a look at it. I believe it has to be implemented by January (or at least you have to start submitting in this form by January 2007)

michael_barnett wrote on Wednesday, November 15, 2006:

The Company i was working for yanked the project.

If you want my files I can zip them up I did a  lot of work on the new form that might help.

tekknogenius wrote on Sunday, November 19, 2006:

Sure send it my way. I’ll have to start on this by early next month. I’ll start looking at the code this week some time.