I am starting to get inundated with requests from insurance companies and intermediaries for our NPI’s so that we can start billing starting early next year utilizing our old ID numbers and the new NPI’s. I was wondering if any of you had been contemplating putting in a field for the NPI’s in openemr, and if you were to request that you also put a field in for the practice name under whose federal tax ID# you do your billing because it has to have its own NPI.
I am using Zirmed (the clearinghouse). Their solution is to enter the NPI in an online profile one time so it does not have to be submitted with each claim.
I am transmitting claims to them directly from OpenEMR with no problems. I am using my zirmed.php script. If anyone is interested in using it, wait until I upload an update which corrects a few bugs. In the current version, you have to copy the claims from a web page and paste into a text file and upload. I am going to put together a system where they are securely uploaded instantly at the push of a button. Zirmed really saved our practice. We are finally getting paid. Other clearinghouses may be good too. It is such an easy way to deal with billing.
Our clearinghouse ENS is doing something similar but that only applies to our electronic claims. All of our workers comp, most of our personal injury, and some of our privates still require paper claims so it would be nice to have those fields available to print on those types of claims. Also did you catch my comment about CAMOS in the help forum?
I know that latest openEMR-2.8.2-dev version in the CVS has support for individual provider NPI in the Address Book section only and you cannot add NPI number under USER menu. Should we add a field NPI in the USER menu to make it more useful and more meaningful?
I also want to propose that we add a field called "facility_npi" for a group practice in the facility table under Federal EIN because it is the requirement for the new hcfa-1500. Once we agree on this, I can work on implimentation of the new hcfa-1500 form under FreeB (I wish we could do away with freeb because of the hassles for installation, but will have to work with it for now.)
I recently make some changes to OpenEMR and FreeB to get it to be able to print the New HCFA-1500. Please let me know where should I submit the new files to.
I need to make some comments about the new FreeB and openEMR 2.8.3-dev in CVS.
First of all, in order for FreeB to work properly, it is necessary to install the new form “misc_billing_options” in ‘./openemr/interface/forms/misc_billing_options’.
This new form will replace “prior_auth”, because the same implementation is included in the new form along with other previously unimplemented HCFA options including:
1) BOX 10 A,B,C: Patient’s condition related to
2) BOX 16: Dates patient unable to work
3) BOX 18: Hospitalization dates
4) BOX 20: Outside lab and charges
5) BOX 22: Medicaid Resubmission code
6) BOX 23: Prior Authorization
The ‘misc_billing_options’ form needs not to be enabled, but the DATABASE should be installed, because certain RPC functions in ./openemr/library/freeb/Procedures.class.php and Diagnosis.class.php files will have references to the form database (form prior_auth is no longer needed).
To print the new HCFA-1500 form, you need to rename the ‘/usr/share/freeb/formatbin/new_HCFA_1500.pl’ to ‘hcfa.pl’. Don’t forget to save the old ‘hcfa.pl’, just in case the new file doesn’t work properly. Also, don’t forget to read the comment near the end of the “new_HCFA-1500.pl” file for a workaround when enter a non-NPI Group ID.
One other thing to change is the “34” to “XX” in the standard.pl, x12.pl files (I’ll do the proxymed.pl since I think I’m probably the only one using it). The 34 is for a social security number (9 digits) and will fail the format checking (at least it does for proxymed) I changed it to XX since that is the designator for NPI numbers.
Maybe we should change the name of the functions from social security to npi since that’s what we’re passing (or create new functions in addition to the socical security freeb functions). I’ll probably do the latter this weekend to make things more clear, just in case someone is using a ssn instead of the NPI or EIN.
BTW that change from 34 to XX would be in the NM1 sections (there are only two places in the files it needs to be changed), since I only use proxymed.pl I don’t have a way to verify if changing those would be correct otherwise I’d make the change.
Hi
I tried changing the 34 to XX in X12.pl and standard.pl. I also replaced the FreeB::FBProvider::SocialSecurityNumber function that followed the 34s to FreeB::FBProvider::NPI. I uploaded the EDI file to Hipaadesk.com and got back an error which states a missing SY or EI.
After poking around I ran into this on this website http://www.cignamedicare.com/edi/dmerc/articles/cope4953.html.
2010AA Billing Provider
NM101 = 85
NM108 = XX
NM109 = NPI
REF01 = 1C
REF02 = PROVIDER #
REF01 = SY or EI
REF02 = SSN or EIN
Does this mean that we need to keep the physicians SSN to use in the EDI file?
I asume
If REF01 is SY REF02 is SSN.
If REF01 is EI REF02 is EIN.