This is very good stuff you are doing. I think this might be the single most important thing for adoption of open source EMRs - in the U.S., anyway.
I'm not sure what is the best way to do this - the EMR will need to know what it's code no.
is at some point, but it might be useful to serve up a list of the possible choices to it from FreeB, then the EMR could convert that into a pick list or something and send the choice back to the FreeB server.
The ANSI X12 is littered with cryptic code choices like
this, for example, in the subscriber SBR segment at element 9, you have to put in one of these
choices for the "Claim Filing Indicator Code". Neat how they used numbers for some, and cryptic
abbreviations for others! It seems to be designed to save bandwidth at the expense of everything else, I guess that will be good for those still sending their claims on their
Commodore 64 with their 300 baud modem. I guess we have to forgive them, since the Internet
was just catching on in 1996 when HIPAA was passed, and I'm not sure if XML had been invented yet! ;-)
09 Self pay LI Liability
10 Central Certification LM Liability Medical
11 Other Non-Federal Programs MB Mediare Part B
12 Preferred Provider Organization PPO MC Medicaid
13 Point of Service OF Other Federal Program
14 Exclusive Provider Organization EPO TV Title V
15 Indemnity INsurance VA Veteran Administration Plan
16 Health Maintenance Organization HMO Medicare Risk
AM Automobile Medical WC Workers Compensation Health Claim
BL Blue Cross/Blue Shield ZZ Mutually defined, Unknown
CH Champus
CI Commercial Insurance
DS Disability
HM Jealth Maintenance Organization
Fred Trotter wrote:
All, FreeB is almost out of alpha and into beta. This coming release will be useable and the only thing seperating FreeB from initial release will be comments from the projects that start to implement it.
Jeff Buchbinder and I are interfacing FreeB and FreeMED this weekend, I wanted to make sure that the system is actually useable and we have improved FreeB tremendously already (As well as repairing some bugs in my code, amazing what another pair of eye can do!!)
We are having some implementation questions that will effect the other
projects, and rather than assume what would be best I will ask what
everyone thinks.
The first has to do with the Place of Service Codes in X12.
Everybill has to have identifiers if it is an office or a hospital
etc... There are lots of options! and goverment payors especially will
pay differently based on which code is used.
There are two ways that the FreeB API could handle getting this information.
it could have a single call.. something like
getX12PlaceOfService()
In which case the Practice Management system would need to track the codes and the values associated with them. The other possibility is to have a series of about 30 seperate calls like
isServiceFacilityOffice() isServiceFacilityInPatientHospital()
etc etc...
Which means that you need to return false for everything that you are not and true for what you are...
This means that FreeB would need to track the codes and what they mean...
The issue is what happens when the standards change... For instance today the code for office is 11. What if tomorrow is is 15? What if there are new codes? By keeping it inside FreeB, some changes can be isolated from the Practice or Hosipital Management projects. But some things will always slip through! There will always be values that a practice mangement system needs to keep in its database for billing alone!!
Please ***BRIEFLY*** tell me which implementation you would prefer and why?
Thanks,
