ideaman911 wrote on Saturday, February 07, 2009:
UHC/UBH has implemented a new portal for X12 submittals at unitedhealthcareCD.com which looks at the X12 with excessive criticality. Some of that deals with clinical reality vs programmer zeal. One big pain is "Onset" in an encounter. Unless a clinician actually knows, NOT by hearsay, putting anything EXCEPT zeros is actually incorrect. Which will cause UHC to reject the claim "because the encounter field has a date, onset must" per their tech people. So your records can reflect your real clinical knowledge while assuring your X12 claim will pass muster (at least for THAT) by pasting the encounter date as an overwrite during claim generation. Use the following addition within the onset function in …/library/claim.class.php near line 842
if (substr($this->encounter[‘onset_date’], 0, 4) == ‘0000’ && $this->x12_partner[‘id’] == 266) {
return str_replace(’-’, ‘’, substr($this->encounter[‘date’], 0, 10));
}
else {
return str_replace(’-’, ‘’, substr($this->encounter[‘onset_date’], 0, 10));
}
then substitute your x12_partner ‘id’ value for 266 as shown. Alternatively, you could create a variable or flag which would be set greater than null if multiple x12 partners had the issue, and substitute that for the x12-partner test. This revision will create the overwrite ONLY in the claim, and ONLY for those partners who explicitly have been defined to do so.