jwallace00 wrote on Monday, January 11, 2010:
Thanks for the tip, Joe.
We’re still getting several errors that are mysterious to me.
MD on-line sends us an error report which I’m using to identify the loop/code information in question. For example, in one of our test claims we have the following response from md on-line: “Loop: 2000B Error: When HL04 from loop 2000B = 0 then SBR02 must equal 18”
In loop 2000B, HL04 is always hardcoded to a value of zero. here’s the snippet from gen_x12_837.inc.php:
"
$PatientHL = 0;
++$edicount;
$out .= “HL” . // Loop 2000B Subscriber HL Loop
“*$HLcount” .
“*$HLBillingPayToProvider” .
“*22” .
“*$PatientHL” .
“~\n”;
$HLSubscriber = $HLcount++;
if (!$claim->payerSequence()) {
$log .= “*** Error: Insurance information is missing!\n”;
}
++$edicount;
$out .= “SBR” . // Subscriber Information
“*” . $claim->payerSequence() .
“*” . $claim->insuredRelationship() .
“*” . $claim->groupNumber() .
“*” . $claim->groupName() .
“*” . $claim->insuredTypeCode() . // applies for secondary medicare
“*” .
“*” .
“*” .
“*” . $claim->claimType() . // Zirmed replaces this
“~\n”;
"
PatientHL is the value being assigned to HL04 in that loop and it is always set to zero. This is confusing since the value for SBR02 fo the same loop gets its value dynamically from the Claim object dependnig on the value in the database.
In the example we’re trying to submit, it’s a claim for the child of the subscriber. The subscriber information is what’s showing up in the x12 submission. I *think* that’s normal, however HL04 appears to be hard coded to always represent a “self” subscriber relationship.
This is the line in question we’re submitting in x12 format:
HL*2*1*22*0~SBR*P*19*SBS235******16~
Field HL04 = 0 but field SBR04 = 19, which is the relationship for a child. The bottom line is, the SBR section of the loop is being coded correctly while the HL section is not.
I’m new to x12 and OpenEMR’s claims process so it’s entirely likely we’ve not set something up right on our end, but that hard coded PatientHL value didn’t look right at first glance. Can anybody shed some light on this for us?
Thanks