This is a re-post from the Help forum, as I would like to get comments on this from the other developers.
It seems that the required hospital admission date is not included in X12 claims for hospital inpatients.
Also there’s no place in OpenEMR to put the hospital admission date or an “onset of illness” date. The billing system uses the encounter date for the onset date, which will not always be right.
So I guess I will add a field or two to the New Encounter form for these dates.
Does anyone disagree that this is the right thing to do?
Hey, You can’t even rely on the EMR encounter date being correct.
The way the current "forms table" handles the date is basically "last form added". This is clearly not the correct date of service. I would like to see the date of creation as the date of service since this should be - in a real time entry - the correct date.
However for the clinics truly using transcription this may not be the case. The billing department may need to override and insert the true date of service as well as the "onset of illness date."
The current "forms" table is a short cut version of the traditional date created/ last date modified/ last date accessed. I thnk we need to modify the logging functioning to record the following pares:
date of creation : creating user
last modified : modifying user
time accessed : accessing user
The current logging is really inadequate. The current logs should be able allow detection and recontruction of unauthorized access and/or data tampering.
I have also had trouble when I dump my database and reinstall - then restore the logs. Sometimes I can’t get the logs back. With HIPPA the logs are as inviolate as the actual clinical data.
Well, the encounter date is actually the date in the "form_encounter" table, not the "forms" table.
The form_encounter date is, I believe, the date that you put into the New Encounter form. My proposal was to add yet another date field to this form (and to the table), to be the date of onset or the date of hospital admission.
I understand. The problem comes when someone posts a new form to an old encounter. The date is now equal to the new form.
Of course, I don’t think the code should allow post dating like this but it does. Clearly this will cause a billing problem that could lead to charges of fraudulent billing or every physician’s friend, a billing audit.
The typical cost of a billing audit in our area is $200,000. It seems that this happens even if you don’t believe you are doing anything wrong.
Believe me, users with no computer knowledge will always find the weakest link.