Working with ANSI 837 5010?

Management and Administration
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#1

Hello OpenEMR community,

The healthcare organization I am working for is transitioning to OpenEMR 5.0.2 and I was assigned to work on our connection with the clearinghouse, Trizetto. I created test patients and sent the information to Trizetto using the X12 format as well as the CMS-1500 TXT (just in case), and sent them the X12 format to have it tested to see if the connection would be valid or not.

The recently sent an email notifying me that the format needs to be ANSI 837 5010, which I thought was what the X12 printed out based on what else I have read on the community and additional research (a small note, I am not a biller, I am a programmer, so these are a lot of new terms for me). Am I missing something since it seems a lot of other individuals using openEMR have obtained the files in the proper ANSI 837 5010 format?

As a follow-up, if this is the right format, when I validate the X12, it shows everything neatly organized, but after downloading it, it displays as a massive chunk of code with no organization between different sections, would this cause any potential errors? I added two screenshots from the demo to display what I see.

While Validating

When validating
When validating1058×875 66.6 KB

After I download the file and check it on my computer.
After downloading
After downloading1388×216 76.4 KB

#2

When you print out the claim, it prints usually in one long line. The text goes on an on.

image
image1687×93 19.4 KB

If you submit the file as is, it should be accepted by the clearinghouse. If not you want to check your logs. When you ‘validate’ it will print errors to the log.

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image882×515 33.1 KB

Looking at my log, there are a lot of errors. For this claim to be submitted I need to go and fix all the settings.

Right away I can see that your facility NPI is missing on the NM141 and NM185 line. Not sure if you need billing contact info, but you might want to add it. You can add the info by going to Administration ->Facilities.

You can see more errors if you look at the log. To make it easier, I would clear the log then re-generate the X12 file.

#3

@growlingflea Thank you for your reply, I haven’t received the X12 information from the company yet, so those aren’t necessary yet, but thank you for telling me how to add those in once recived.

And so if I understand this right, it is already ANSI 837 5010 format?

#4

hi @Endelis, it’s 5010, see the GS record 005010X221A1? The 837 is created as one long string of text.

#5

Thank you,

Stephen, that really helps me understand now. I will return to the clearinghouse and notify them that it does fit their format and see if there was anything else I needed to give them. Thank you again!