I am not yet using OpenEMR in my practice, but hope to be soon. One issue that will come up has to do with different insurance sources for the same patient. I am part of a Plastic Surgery practice. We might see the same patient for a Worker’s Comp injury, a private insurance skin cancer, and a Cosmetic visit for Botox. Our current (imperfect) solution is to have a separate chart for each payor type, so the Worker’s Comp insurer only sees the paperwork for the Worker’s Comp injury, etc. We could create several “virtual patients” under OpenEMR, thus mimicking our current paper system, but it would be more elegant to have a single patient, and have each visit assigned to a particular payor type. Does OpenEMR have any such capability?
That would require some software changes. OpenEMR supports multiple insurers per patient, but they are primary/secondary/tertiary and so each is expected to see each claim. What we’re lacking is any concept of multiple independent primary payers.
I think that this has been an issue for primary care practices that have a new Workers Comp case opened when the patient is established for other medical care. This happens often enough in my experience to warrant more than a workaround. This was genuine worry for our office manager as we looked at OpenEMR. It is not acceptable for instance to include anything about a chronic illness in a note for a visit paid for by Workers Comp. They have created their own world. This means that not only does the insurance type require segregation, but the notes and encounters also. Sort of the “virtual patient layered on top of the real patient” as alluded to above. We have in fact submitted a WC claim and a standard insurance claim for the same pt on the same day with separate notes documented in the record. Jack
I am not sure if any commercial EMR can handle this scenario. Prior to OpenEMR we used Amazing Charts ( huge waste of money by the way) and we had to create a separate patient chart for a Workers Comp claim just like we do with OpenEMR. This was the best way to keep Workers Comp stuff isolated. Like Jack said, “it is not acceptable for instance to include anything about a chronic illness in a note for a visit paid by Workers Comp.” To compound the problem, we have some patients with up to 7 separate work related injuries or claims. As you can imagine, we have the same patient name entered 7 times in the OpenEMR database associated with their individual Workers Comp claim ID (this is our pubpid). Having separate patient records for each claim ( although seems inefficient) is the best way to keep each claim’s notes and documents organized. It also helps with scheduling follow ups on the calendar. If anyone has a better way to handle this I am all ears.