On a health care biller’s perspective, once the claim is generated in X12 format in an EMR and ready to be submitted to a clearing house, Is there any option or an application or any online portal that could assist in validating the generated X12 file for mandatory fields, segments and provide clear error intimations with respective to the submitted X12 file before the claim is submitted to the clearing house.
Share your views, ideas with opensource applications that is available to validate the X12 file.
This helps a lot to healthcare biller in reducing the rejections of the claim after submission.
But what I look for is something, that could automatically scrub my X12 claims (Not within the billing application) and intimate me the errors that should be corrected before submitting it to the clearing house.
To be more clear: I look for a portal or a website where I could upload my X12 files and get known about the issues within the uploaded file so that I could solve the encountered errors and then submit it to the clearing house.
This will reduce the time and complexity involved after submitting a claim and reduces the possibilities of getting the claim rejected by clearing house and insurance companies.
I think what you are seeking is not readily available nor optimal from a security perspective.
Error tracking is most likely to be specific to the application generating the 837P. A third party website that tracks errors over a range of PMS’ would be difficult to find. A quick Google search has confirmed this.
If your billing service is located in the U.S.; be mindful of the fact that the fewer places the PMI’s are dispersed, the more secure they will be & the less likely a HIPAA violation.
In our practice the error tracking from the View Log does a pretty decent job of scrubbing. Occasionally when we have the wrong insurance ID number, the clearinghouse will pick it up with the second scrubbing.
In essence you may be seeking a unicorn.
What I would suggest is asking assistance from the clearinghouse to introduce additional scrubbing parameters into the View Log to keep the number of secondary scrubbings to a minimum.
It is in their interest to help because the more error free your 837P’s, the less handling of the claims for them.
You will need one of the developers to customize the code.