As reported on another thread, I’m running test X12 files through Office Ally now with pretty good success. At least they are making it into their system, and sending back errors that make sense to me.
However, after generating an X12 file and viewing the log as recommended, I am faced with the following errors that I have not been able to figure out:
1: “*** Payer-specific provider insurance number is present but has no type assigned.”
I can’t figure out what “type” field this is referencing. The “type” on the insurance company screen is set as “Medicaid.” I can find no “type” field on the part of the demographic page where one enters the patient’s insurance information. What is this error message referring to?
2. “*** Rendering provider has no NPI.”
I assume that I am seeing this because I left the “provider” fields set to “default” on the fee sheet? Am I correct in my assumption that this is causing the error? Have I overlooked a “default provider” field somewhere (I completed the “provider” field on the demographics page).
3. The fee sheet in question says “This encounter has been billed. If you need to change it, it must be re-opened.” Quite right. But, since it was only a test billing, how do I go about re-opening the encounter.
I am recommending Office ally to one of my Doctor friend. Is it possible for you to rune me through step by step as to how you had gone about integrating openEMR with office Ally. Step by step procedure….
From the point of view of setting up Office Ally, it is very simple. Once you create an account with them, they schedule a training session. During that session, they remotely access your desktop via GoToMyPC, and walk you through the setup process.
Thence, the process is simple:
1. Run billings (radio button on left side of OpenEMR).
2. Choose appropriate date range.
3. Choose (checkbox) encounters to bill
4. Hit “Generate X12” button.
5. View log for possible errors (I still haven’t solved all of those).
6. “Generate X12” will create an X12 compliant text file, which you can edit with Notepad or Notepad++ or similar. I just put mine on the my Windows desktop.
7. Log onto OfficeAlly web site, choose “upload file,” browse to the correct text file, and hit “upload”
8. Receive e-mail with confirmation number
9. Several hours later, you will receive an e-mail from Office Ally telling you that your claim file has been processed. You can then log back in to Office Ally and download an error summary file.
10. Most errors can be corrected on the OfficeAlly web site, then tagged for retransmission.
I got my first claim all the way through Office Ally and “initially accepted” by Aetna. So, I’m through the system, I think. Wouldn’t it be a hoot if they sent me a check? We’ll see…probably too good to be true so far.
In fairness, a few years ago I set up a commercial software application to submit X12’s to West Virginia Medicaid via Unisys. That was a MUCH more finicky operation that OpenEmr was with OfficeAlly! Kudos, developers!! Of course, since OfficeAlly does not have a link established to WV Medicaid yet, I guess I’ll yet have the experience of getting OpenEMR to work directly with Unisys. Keep your fingers crossed.
Raj, feel free to call anytime, but remember I’m only a fellow neophyte. (304) 520-oh,oh, ninety-five.
Mike:
I am also new to OpenEMR. I am testing the claim generation part and I am getting the same error “Rendering provider has no NPI”. How did you fix this problem? I have setup the individual provider with an NPI as well as the facility. What am I missing?
Frankly, I just ignored it. It doesn’t seem to hurt anything, and I never did figure out what triggered it. I the end, I completely quit looking at the error log because I never found any useful information in it, and my X.12 files worked just fine no matter what.
As to uploading the file, my only experience is with the Office Ally clearinghouse (www.officeally.com), which has worked very well for me. You have to call them and set up an account before doing this. Then:
1. Download the X.12 file to your PC (I just put mine on the desktop, then delete it after I upload it).
2. Log onto Office Ally and click “upload file”. Browse to the X.12 file on your desktop. Click upload.
3. You will see an upload confirmation number on Office Ally
4. Delete the text file from your desktop
5. Yes, it really is that simple.
Having said all of that, I have made the decision, after using Open EMR in a production environment in my solo psychology practice for too much, to switch to Office Ally’s free Practice Mate product. I have great respect for Open EMR and the folks who built it and maintain it, but I found the whole billing routine to be clunky and confusing, and there is a lack of useful reporting capability. As my volume increases, I think it would become unmanageable for me shortly, with the tools provided. Also, Practice Mate provides integrated appointment reminders (either phone or e-mail) for a very reasonable $29.95 a month. I think that that alone will be sufficient value for me to make the switch.
BTW, I learned about Office Ally in these forums. Overall, my experience with Open EMR has been very rewarding.
OK Thanks
I was under the impression that the upload to the clearinghouse was done directly from OpenEMR. I was looking for some screen with a button to click for uploading the X12 file to the clearinghouse that I have configured under the Admin section.
I am still having problems with the Rendering provider has no NPI. I am sending the claims to a clearinghouse and they are complaining about the same error with the file I sent. Any ideas?
Go to the fee sheet for that encounter. at the bottom of the fee sheet select a default provider. That should fix your issue. Also make sure under that provider’s user information in the admin section that their NPI is filled in.
Chris
I am sorry I forgot to mention that was the very first thing I checked several weeks ago. I keep going to the fee sheet and admin section to double check and reenter the values. I still get the same error.
OpenEMR is great, but the documentation is not enough for one to be able to understand how everything works, like billing.
Is there any other field that I may have missed that could cause this problem?