I am trying to submit claims to Idaho Medicaid and I received the following error. Element PER02 (Name) is missing. This Element’s user option is a ‘Must Use’. Segment PER is defined in the guideline at position 045. This Element was expected in: Segment Count: 5 Element Count: 2 Character: 293
I looked in the gen-x12-837.inc.php and found the section for 1000B where it calls the BillingContactName and BillingContactPhone. However my problem is I cannot find out where to enter that info into the database.
If someone could point me in the right direction it would be greatly appreciated.
Thanks in advance for your help and an awesome product.
I believe I am correct in saying that you need something in the insurance setup that lists the point of contact for the payer. For instance “Claims Rejection Department, Dewey, Cheatum, and Howe Insurance Company” I believe our medicaid POC is Amy Rice (Florida). “Claims” might be good enough .
I looked in the gen-x12-837.inc.php and found the section for 1000B where it calls the BillingContactName and BillingContactPhone. However my problem is I cannot find out where to enter that info into the database.
The billing contact and phone number, I believe, is entered in the facilities UI under administration when the faility selected is the billing location.
Thank you both aethelwulffe and zhhealthcare for the very quick response. I entered a contact name in field where it says “Billing Attn:” in the practice-facitlity pop-up and that fixed that issue. Thanks again for your help and your quick response John
One last question on this batch with errors. I need to have a facility ID entered into the 2310B loop ref segment. I thought that if I used the Facility NPI field that would take care of it. However, I guess its erring out because that field is only suppose to be 10 digits, the length of the NPI. Where would I enter data into OEMR that would then be carried over to the electronic file in the 2310B loop, ref segment. Thanks again for your help it is greatly appreciated
I think (and once again I am giving an off-the-cuff answer without checking the EMR) that 2310 is not a facility ID. GS02 is what it sounds like you are describing….or even more likely, the ETIN, which is set up in the x12 partner data. That is a required 9 digit field.
Are you positive that it is 2310b we are talking about?
Loop 2310B - RENDERING PROVIDER NAME
NM1*82 - Rendering Provider Name
NM1 - Rendering Provider Name, Tax ID and Provider ID#
NM103 - Rendering Provider Last Name
NM108 - Rendering Provider ID Type
NM109 - Rendering Provider ID
PRV*PE - Rendering Provider Specialty Information
Just double check for rendering provider name, check their NPI, check their Taxonomy, check their tax number, any required insurance numbers (not applicable for Medicaid I believe). I think 2310b REF02 is supplied by the “provider insurance numbers” stuff. I’ll check it about noon-thirty or so for you and post.
aethelwulffe, you are completely correct, it was my mistake I meant loop 2310D seg NM101. Again my apologies and thanks so much for your help and swift response. John
Well, if it were two digits, that would be location code, but ten spaces sounds like a location name. I would check your “facility” to make sure that you have something in each spot for that particular facility. If the facility is “Office” and your location code is 11, you should be pretty well off. Just be advised that if you are using location code 00~09 (we use 03-School ourselves) the location code will be erroneously entered as a single digit in the x-12. Look for the thread here (I think under “Help”) titled “03 location code problem” or something like that. For 3.2.0 I tracked down this bug and Rod helped me with some code to make sure it always gets entered as two digits, as the database will store 03 as a “3”. I am not sure at all that this is the error that you have (real sure) but your facility needs to be checked. Make sure you have the locations correct, make sure you have it properly marked as a billing location if it is so, and all that rot. As I have set up some facilities that are not “billing locations” and had them work fine, I can give you some examples of things know to work in some cases at least.
aethelwulffe, thanks again for your quick response and the loop and segment information. I called the Idaho Medicaid EDI department and got some specifics. She looked at my file and said that the data they want needs to be in the 2310D loop REF 01 and REF 02 The REF01 needs to have the Qualifier LU and the REF02 has to have a number similar in format to 12345678910-123. My question would be where would I enter this into OEMR so that it pulls it and puts it in the file. Thanks again for all your help and explanations. John
In Administration->Practice, select Insurance Numbers. For the provider in question fill in the following:
Insurance Company Idaho Medicaid
Provider Number 12345678910-123
Provider Number(Type) LU ← select from list
Hmmm. I guess Idaho Medicaid is different from Florida. We did not need any provider numbers in there, though I guess we should fill those in for other reasons (such as FARS/CFARS reporting in our LBF forms we have). LU is location number, right? I would think that it is the Medicaid provider number (1D) that they want.
Tony, that was it, however it isn’t putting the dash “-” between the the numbers “1234567879-123” its running the whole number together when I look at the file I should send “123456789123” instead of “123456789-123”. If you could tell me where to fix that it would be awesome. I believe this is my last hurdle. Thanks so much John
As you can see in the last line, the ‘dash’ is specifically being removed. There is probably a reason for that :-) but insurance companies are notoriously picky. It may be better to drop the forced formatting and really on clean, correct data entry.
I’m honestly not sure if dashes should be allowed. The spec seems to indicate they are, but there might have been some issue in the past with them. I’d suggest allowing them and see if anything bad happens.
Tony, thank you very much for giving me the info on how to eliminate the “-” it worked like a charm. Lets hope the claim doesn’t deny for any other reason. Thanks again for your help John
Sorry to wake up this thread again either I can’t remember what I did to get the claim to go through or I mistakenly thought it went through because I saw the LU*123456789-123 in the file and didn’t notice it was in the wrong loop 2310D. When I look at the file created after making the changes to administration->Practice, select Insurance Numbers. I find that the info is in both the 2310B and 2010AA loops however, it isn’t putting the REF*LU*123456789-123 in the 2310D loop. When I look at the facility info it doesn’t have a place to input the number or a place for the drop down to choose the qualifier. I am going to see if I can modify the facility pop-up to allow the same configuration “stuff” that the administration->Practice, select Insurance Numbers allows and then configure the gen_x12_837>inc>php to pull that info. If there is an easier way or if I am missing a step to put that info in the 2310D loop it would be greatly appreciated. Thanks in advance for your help. John