leongruenbaum wrote on Thursday, March 10, 2016:
thanks, fsgl.
thanks a lot. i apologize for the delay. this is a client i see only weekly and i wasn’t back here til now
just a note to remind u i did the hard coded 5010 fix and it didn’t change anything
How was the X12 Partners dialog configured originally when Post-n-Track support helped you with the initial setup?
i wasn’t here for the original set up but i imagine we were on phone with them and got the information. see attached.
How does the Doodad Utility Tool work? (Sounds like a Southern dialect.)
doodad takes the x12 files generated by openemr and sends them to postntrack. they assign some sort of case # and let us know within minutes if they have been accepted (at least initially, i.e. if they have a technical fault)
Did support configured one X12 Partner for all your insurers? Or did they configure a separate X12 for each insurer, e.g.; one for GHI, one for Aetna, one for Unitedhealthcare, etc.?
we have only postntrack as our x12 partner. sounds like that is the correct way to do it, yes?
The way it’s done at Office Ally is that only one X12 is configured for the clearinghouse, Office Ally. All our insurance companies will use that one X12 Partner, Office Ally. This makes things simple, like one-stop shopping.
If you have a separate X12 Partner configured for each insurer, this may be the source of the problem. There could have been a wrong selection in the Insurance part of the Patient Summary (Demographics) for this particular patient. An incorrect X12 Partner may have been designated for GHI in Practice/Insurance Companies or in the Billing Manager just before you clicked the Generate X12 button.
We should look at the screenshots for this patient. Black out the name, DOB, any other PHI for the patient & credentials for attending physician (NPI, Employer Tax ID) or use fictitious data before attaching screenshots.
Needed screenshots:
1.Insurance section of Patient Summary.
2.X12 Partner dialog box for GHI used for this patient.
3.The pending claim of this patient in Billing Manager with the choices of the X12 Partner drop-down menu depicted.
ok see attached - i also included the full x12 file that is generated for this person, with the missing data. i have made the info generic as u can see.
btw we recently made some adjustments which seemed to let us include GHI and Empire Plan, which previously weren’t working. (At this moment i am forgetting exactly what we did.) Some of those now do work; however, both of those providers - and this example is one of them (GHI) - have generated this type of file w blanks in it. We have never had this type of missing data with the other providers: Cigna, Aetna, United Health Care, Oxford. those all work consistently (btw, postntrack does not accept blue cross blue shield)
anyway i have attached everything u asked for - 3 jpgs and a text file. wasn’t quite clear which screen u wanted regarding billing. what i am attaching doesn’t show anything about x12. anyway, there is only one x12 partner in the system: postntrack
Another option is to have you replicate the scenario in one of the Demo’s so troubleshooting would be more accessible.
We usually are able to diagnose the problem if we have enough information & if we go through the differential diagnoses methodically.