X12 Problem Change Healthcare

Situation
With version 6.1, the X12 files being uploaded to Change Healthcare (Formerly Emdeon) are resulting in a rejection with the following error:

SUBMITTER ENTITY RELATIONSHIP CODE IS NOT TO BE USED ( Bad Data: 62274749)

and in the “View Correction” details of the claim:

  • 1000A~NM1~10 SUBMITTER ENTITY RELATIONSHIP CODE IS NOT TO BE USED;
    Copy of Bad Data:62274749; Element Number:706; Segment Position:3;

OpenEMR Version
I’m using OpenEMR version 6.1

Browser:
I’m using: Doesn’t Matter

Operating System
I’m using: Doesn’t Matter

Logs
Did you check the logs? Not Y
Was there anything pertinent in them?
Please paste them here (surround with three backticks (```) for readability.
You can also turn on User Debugging under Administration->Globals->Logging User Debugging Options=>All

I created an X12 file for the same patient visit in 6.0 and 6.1.
Here is the diff between the 2 files:

mark@ThinkPad-X1-Sarnov:~/temp$ diff x12_6.0.txt x12_6.1.txt
1,2c1,2
< ISA*00*          *00*          *ZZ*<My ID with CH>       *ZZ*263086998      *220416*1128*^*00501*650122925*0*P*:
< GS*HC*<My ID with CH>      *263086998*20220416*1128*1*X*005010X222A1
---
> ISA*00*          *00*          *ZZ*<My ID with CH>       *ZZ*263086998      *220416*1130*^*00501*000817160*0*P*:
> GS*HC*62274749      *263086998*20220416*1130*817161*X*005010X222A1
4,6c4,6
< BHT*0019*00*6501229250001*20220416*1128*CH
< NM1*41*2*HARMONY HEALTH OF WNY*****46*<My ETIN>
< PER*IC**TE*5856843556*EM
---
> BHT*0019*00*1*20220416*1130*CH
> NM1*41*2*               ******46*<My ID with CH>       
> PER*IC**TE**EM
34,35c34,35
< GE*1*1
< IEA*1*650122925
\ No newline at end of file
---
> GE*1*817161
> IEA*1*000817160
\ No newline at end of file

Any help would be appreciated!

checkout the changes to the X12837P file here @Mark_Sarnov

Thank you… BTW: I have isolated the error on Change HC website to line 5 of the 837 file:

NM1*41*2* ******46*<My ID with CH>
should be

NM1*41*2*HARMONY HEALTH OF WNY*****46*<My ETIN>

I think… ?

Ok… I’m learning a lot about X12 5010 claims… Sheesh.
Replaced the X125050837P.php file with the most recent and the ETIN replaces the submitter ID on line 5… Cool.
But the office name is not populated.
This traces to the Loop 1000A Submitter and in the UTD php file.

Not sure what to do to get the name of my practice to populate line 5 (if it is necessary)

Thank you!

Ok… made progress. I populated the field in the Change HC X12 settings to include my office name in the “Submitter Name (3rd Party Submitter Only)” field, and it now populates.

Why was it populated in 6.0 without that field entered, but not in 6.1?

N.B. Ok… when I populate the “Submitter Name…” field, the Submitter ID populates instead of my ETIN…

I’m going nuts here! :stuck_out_tongue_winking_eye:

Thanks again!

looks like a bug @Mark_Sarnov, if there’s no submitter name it should populate with the facility name, thanks!

Hi Stephen,
I think there is a problem with the nesting of the if…else statements that is screwing up the logic in the 1000A submitter.
And, I know it’s repetitive, but the “NM1”, “41”, “1” or “2” should be entered within each of the FOUR (4) logic statement blocks.
I think the logic is:

if Fed ID type is "SY" then {
         if 3rd party name exists then {
            Create 3rd party name with Submitter ID
         } else {
             Create provider name with Facility ETIN
            }
} else Fed ID is NOT "SY" then {
         if 3rd party name exists then {
           Create 3rd party name with Submitter ID
         } else {
            Create Facility Name with Facility ETIN
           }
}

I think that trying to conserve code (always admirable) by having the first part of line 5 of the 837 EDI just after the first “if” statement, the formatting of line 5 is corrupted.

or… the french brackets are just screwed up!
FWIW, IMHO, OU812

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Come to think about it… it might be better to perform this process as a “function” call.

Function EDI1000A(“entity_name”, “entity_type”," ETIN/SubmitterID")

so… for each logic block, you can simply write:

$out .=EDI1000A(A,B,C)

for the block that requires the firstname,middlename,lastname,suffix, just execute a concat statement before passing the A parameter.

using function calls for each envelope part of the 837 might actually use less code.

IMHO, FWIW, 5150.

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