markthepharaoh wrote on Monday, February 16, 2009:
Hey,
I have created an electronic claim:
2009-02-15 20:06 Queued for primary standard billing to Vista Health Plan
2009-02-15 20:06 Claim was generated to file 2009-02-15-2006-batch.txt
How do I send it, I do not see any button as in the previous version that says "Start batch processing?
I also created two of those batch txt for the same encounter; how can I delete one of them?
I appreciate your help! Thanks.
Mark
markthepharaoh wrote on Tuesday, February 17, 2009:
Any help would be greatly appreciated!
anojgoel wrote on Tuesday, February 17, 2009:
have you checked with vista health plan. usually there is a place to upload the saved file thru internet.
other option will be to contract out with a clearing house and than you can upload your saved file to them for further processing? this option saves you from going from one health plan to another.
i guess a page can be created in openemr with links to different plans that accept electronic filing.
ideaman911 wrote on Tuesday, February 17, 2009:
I am not aware of anything within OpenEMR which directly submits to the payers (or clearinghouses). Since they and their respective portals would be so variable, I doubt it is worth the programming effort to make it so, unless you do all billing through the same portal, as with a clearinghouse.
I personally prefer to not automate it. That will allow me to modify as needed when the portal processes change (frequently) and/or we add and drop payers.
What could be a valuable addition, though, would be the 270 bi-directional to allow patient verifications with any X12 partner you can. We are having fits because of lack of verification, which is a time consuming, and therefore costly, process. If the 270 process can provide the check automatically, and flag patient data when they are not eligible, that would allow front office to put a hold on the appointments. Insurance companies see no ethical conflict with THEIR refusal of medical service, just yours.
markthepharaoh wrote on Wednesday, February 18, 2009:
Thank you so much for your responses, in manual for earlier versions such as 2.8.3? ; that is the manual in the website under basic billing chapter a freebee module was add that enabled electronic billing, create a batch send it and receive a response from a clearing house or a payer! and I was under the impression that this feature became an integral part of the oemr starting at version 2.9.0! Did I misunderstand? There is a batch processing button that becomes active as soon as X12 is created? Would you please advise?
What is the 270 bi-directional?
and I will be submitting claims to clearing house.
Thanks a lot for all your input.
Mark
anojgoel wrote on Wednesday, February 18, 2009:
location of your batch.txt file is at openemr-edi folder.
you should be able to load this file to your clearinghouse by following your clearinghouse directions.
anoj
ideaman911 wrote on Thursday, February 19, 2009:
Mark et al;
I have not yet worked with them, but 270 files (who dreams up these designations? 
allow you to query the insurer about patient elligibility, and get their responses, automatically. They have both single-patient and patient-batch types of files. As with the X12, there is a host of protocols which must be met. But the key value to that effort will be the ability to know before you next see a patient whether you will be likely to be paid (note I said "likely" because a river in Egypt is their first response
The downside to ALL the X12 etc is that computers are in the middle. And computers are idiots who have no tolerance for missing information, mis-spells or a host of other issues which insurers stopped bothering with because THEY had to absorb added costs to enter all that when we worked with paper. They had the info already, so why bother entering it repeatedly. Say goodbye to that comfort zone, though. YOU do all their keying, so they see no problem with insisting on YOU paying for ALL of the info, no matter how irrelevant. What, for example, does it matter that WE don’t know the birthdate of the parent of a patient - we now for certain that the insurance company does, so why do WE have to provide it in order to bill for care we provided to the child? HIPAA is used as a bludgeon on providers, even while the CMS which insists on it is exempt from its compliance.
If an industrial engineer (I am one) ever looked at the health care payments process, he would want somebody in jail. And don’t get me started about stupid stuff like UHC making their ID cards have a background which blacks out on faxes. Again, a River in Egypt…
The good news is that if you see a patient more than about four times, having used OpenEMR will become more efficient than manual process could ever be, and the ability to use X12 (once you get past their portal filters) makes billing receipt (read that "cash flow") so much faster, that I wonder why the experience of even those buying expensive EMR systems has been in large measure to stop their usage. I suspect it is the up front cost of conversion of their existing database (paper in most cases) and the hassles of techno-cost, which can become a vast wasteland consuming practice resources.
OpenEMR is not immune to this reality. In many ways it is MORE costly, despite being "free", because it needs nerds like me to fix it so it works efficiently. But that is also both its strongest suit and the reason I am writing this - because it CAN be tailored to the specific practice needs. And now that we have it ported to Windows, the potential users have expanded exponentially. And the more people like me who share that knowledge, the lower the cost for all of us in the same boat. Have fun.
Joe Holzer im@holzerent.com
markthepharaoh wrote on Saturday, February 21, 2009:
Thank you all for your genuine support, it has been a great help. Hey Joe, I am a fellow engineer too; mechanical by education, environmental by experience!