Undistrbuted funds after uploading an ERA


(Stephen Waite) #43

just noticed the CO*144 with MIPS this year and without this fix it clutters the eob screen and should probably work to clean up the billing statement by combining all similar adjustments to one line

the table might help with presenting the denials on the output of the EOB posting page where one could view only zero paid claims and exclude deductibles so a biller could focus on which claims need follow up; sometimes a little investigation/inquiry helps make the payer take responsibility


(Daniel) #44

@stephenwaite @brady.miller
I am going through the parse_era.inc.php file and I am having trouble figuring out the logic behind declaring the loop after running the parse_era() function.

When we are going through the CLP portion, CLP falls under the 2100 loop. Yet, when we read the CLP line

we send the CLP info to the parse_era_2100 file but the loop_id is ‘2000’ when $out is sent, event though it should be 2100. The loop_id doesn’t become 2100 until after the parse_era fn is called.

Since the value of loop_id is 2000, it doesn’t meet the if statement critera to get processed:

Is there something I am missing or should lines 208 and 209 be reversed?


(Stephen Waite) #45

hi @growlingflea, think you’re right, it’s actually being successfully called here in 5.0.1


(Daniel) #46

Also: Is there any reason why we don’t have the ability to view the A/r and edit it? I think that might be a solution.


(Stephen Waite) #47

is the problem still undistributed funds due to multiple cpts on the remittance but only one cpt was billed?


(Daniel) #48

For this customer, only one CPT per encounter. But, I did notice this difference between the two versions (500 and 501)

and here is a portion of the EDI file that is returned when the 243 code is sent

image

In the version of 500, the adjustment codes were added to the ar_* tables. Since the value is blank, the isset($seg[6]) returns false, instead of true. This prevents this claim from getting added to the a/r table since no funds were transferred.

I do get an error message but I think the end user should be alerted via a different method than a “popup”.