I am in my first few days of using Zirmed. It is really a relief after suffering with trying to submit paper claims. They do a lot of screening before claims go out. The interface for correcting problems is easy to use.
I have the program for generating claims in the Zirmed ‘pipe format’ mostly finished. It works for me, but there are a few fields hardcoded in because I wasn’t sure where to query them from for each encounter. It is all contained in a single php file with an interface for setting a date range, filtering by pid and insurance company. I will clean up a little and upload it. If I can’t figure out the hardcoded fields easily, I will just leave them as constants for the user to change in the file for now.
The page lists the claims, one per line, and then you just copy & paste to a file and upload it to the Zirmed website. Keep in mind that Zirmed requires Internet Explorer.
I guess they call it the pipe spec. I was told that I could submit my claims in a csv format, so I asked for the specs to generate them. The pipe spec is a specification consisting of 299 fields that have to be generated on one line per claim seperated by the ‘|’ character. That’s where the name comes from. The fields correspond to fields in the HCFA 1500 form. One reason there are so many is that every checkbox is it’s own field. If a checkbox is to be selected, it gets an ‘x’. If not, it is left blank.
For now, I am planning to track receivables in the billing table.
Firefox works if you just want to look, but some stuff doesn’t work. This prevents me from using a Mac because Internet Explorer is no longer supported for the Mac. Microsoft recommends that Mac users just use Safari. If you try to use Safari on Zirmed, they forward you to Microsoft to download IE! Good thing I didn’t sell my Windows laptop. When I can afford it, I will just upgrade to an Intel Mac and get the Parallels program to run OS X and Windows together.
I think you’ll find that the billing table as it exists today is not adequate for recording payments and adjustments. Also in the case of secondary claims, it has no provision for retaining the information about both billings.
In case you’re interested in working on it, I do have some specific ideas about enhancing the database structure for these things. Feel free to ping me offline.
I was generating a claim today and discovered a bug that led to a significant rewrite of my loop for picking up encounters. It is really a problem due to the fact that billing table entries are mostly independent of encounters and it is more tricky to bring them together than I anticipated. I believe that most of my submitted claims will not be affected.
The problem comes up if a CPT4 is added on a different date than the encounter. This might happen if documentation is done late or if an error is corrected. Now the date of service shown in Box 24A of the HCFA1500 is not consistant with the date of the encounter.
I believe that my new rewrite completely fixes the problem and gets the date from the encounter rather than the billing table.
I have also fixed some hardcoded variables including user id, place of service, and facility id. Errors will occur if the data is bad. For example, if a user other than the treating physician enters CPT4 codes, this could throw off the user id, because that’s where I get it from. If the facility name does not match one in the facility table, there will be an error.
It is really a mess trying to tie together this strange data structure of OpenEMR and make sense of it in terms of claims, but I think it is working fine now. Maybe a little more testing and I will upload this weekend.
It is critical that users know where to put practice info and that they are careful in entering data correctly for practice and for encounters.
It is in the contrib directory. I stupidly uploaded it as a .tar.gz file. I think I fixed a few bugs since that version, so I will add and commit it properly as a .php file. There are a couple of hardcoded variables that you have to set in the file at the top. I use it every day and it works for me.