Summarize all table row-counts in a single query

Provider Identifiers

When we send claims to the insurance companies, it is very important to give the different provider numbers or identifiers for processing the claim. Let us understand different provider numbers.

DEA (Drug Enforcement Administration) Number

This is a unique number that is issued to every provider that prescribes any type of controlled medication.

What is Controlled Medication

Most prescriptions for infections or for chronic conditions are non-controlled. For example, most blood pressure and cholesterol medications, diabetes medications, asthma inhalers, and antibiotics are all non-controlled medications.

Controlled substances are medications that can cause physical and mental dependence, and have restrictions on how they can be filled and refilled. They are regulated and classified by the DEA (Drug Enforcement Administration) based on how likely they are to cause dependence. Some examples of controlled prescription drugs include :Morphine,Oxycodone,etc

EDI 837 Professional Loops

EDI RESTful Web Service API

Are you looking for RESTful Web Service API to generate HIPAA X12 EDI Transactions? Then here is the solution offered. Please contact me for more details

Create an account in our Nagata EDI Tool and check  HIPAA X12 EDI Transactions sets.
Here is the demo link
https://demo.nagatabilling.com/NagataEDITool/login.zhtml 

1. JSON to EDI 270 Eligibility and Benefit Inquiry
2. Create EDI 270 from JSON
   
3. Parse EDI 271 Message to Human Readable Text
4. Parse EDI 277 Message to HTML
5. JSON to EDI 837 Professional Claims
6. Parse EDI 837p Message into JSON
7. Parse EDI 835 Message into JSON   
8. Parse EDI 835 Message to PDF
9. JSON to cms 1500 Form
10. Parse EDI 837p To HTML
11. JSON To EDI 837 Institutional
12. Parse EDI 837I to JSON
13. Parse EDI 837 Institutional To HTML
14. Create CMS 1500 Form using JSON
15. Parse EDI 837p to CMS 1500 Form
    
    
    

 

 

 

 

 

 

ASC X12 270: Eligibility, Coverage, or Benefit Inquiry.
This transaction allows providers to check whether a patient has insurance coverage as of a specified date. This transaction is typically sent by healthcare service providers, such as hospitals or medical facilities, and sent to insurance companies, government agencies like Medicare or Medicaid, or other organizations that would have information about a given policy. 

Minimum information such as Member Name, Date of birth and gender or subscriber ID is required to submit in the 270 message to get the response. If we are doing real time mode, then the expected response time will be  1 to 2 seconds.

Sample Workflow

1. Provider Smith uses ABC Billing Software aka Practice Management Software(PMS).
2. Provider Smith already signed up with XYZ Clearing House and an ID has been assigned to Provider Smith by the clearinghouse.
3. ABC Billing software has the option of generating EDI 270 messages and through web service call, it will send the message to the clearinghouse.
4. XYZ receives a message within a few seconds and then identifies the message for Payer Cigna. Since XYZ already enrolled with Payer Cigna, so it just forwards the message to Payer Cigna via web service.
5. Payer Cigna receives the message and prepares response 271 and sends it back to the clearinghouse. Immediately clearing house forward the response to the Provider Smith’s ABC billing software.
6. ABC Billing software parse the EDI 271 Message into Human-readable text and show it to the user.

 Download sample EDI 270
 Download Sample EDI 271
 Parse EDI 271 To HTML
 Parse EDI 271 To Text
 Parse EDI 271 To JSON

Parse EDI 837p Message into JSON

EDI 837 P Budget Number Example

Hire me

You can hire me for any of the following

1. Training on X12 EDI Transactions to support your current job.
   
   
2. If you already developed EMR and planning to add Billing Component as an integrated solution, then you can hire me to help your team both functionally and technically. 
   
   
3. You already have an inhouse development team and want to work with your team to enable all the EDI transactions, then you can hire me to support both Technical and Functional areas.
   
   
4. You already having an inhouse development team and looking for Restful Webservice API to generate X12 EDI transactions, then you can hire me to deliver the source code for the same. I've developed Restful Webservice API using Latest spring Boot version for all the Healthcare EDI transactions EDI RESTful Web Service API
   
   1. JSON to EDI 270 Eligibility and Benefit Inquiry
   2. JSON to EDI 837 Professional Claims
   3. Parse EDI 837p Message into JSON
   4. Parse EDI 835 Message into JSON

5. If you are having an RCM Billing company and if you would like to automate some of your routine billing works, then you can hire me to develop/design/help for the software. I’ve 5 years of experience as RCM Manager.3 If you are developing or planning to develop EMR/EHR/Medical Billing Application/Practice Management System, you can hire me as a subject matter expert for both Technical and functional areas. I can help to develop the application from scratch To end go-live mode. This arrangement involves the following responsibility

• Database Design (MySQL or SQL Server)
• UI Design Ideas
• Java Spring Boot web API Source code
• Reporting
• Dashboards

Parse EDI 271 Health Care Eligibility Benefit Response

Medical Billing Terminology

Mysql Query for Aging To Count No of records

JSON to EDI 837 P

 

 

Are you looking for creating X12 EDI 837p using JSON Format? Here is the solution offer. Please contact me at vbsenthilinnet@gmail.com for more details.

Sample Webservice Call

Internal Tool demo to Test the Webservice call

Are you looking for a solution to generate 837P or 837I in your medical billing product? Then you are in the right place.

I am Senthil Muthiah, A technology-driven professional with over 20 years of experience including nearly 9 years in Software Development and Business Analysis.  Well versed with US Healthcare Domain – Electronic Medical Record (EMR) & Medical Billing. In particular, 15 years of experience in the Healthcare domain specifically in Claim processing, Claims adjudication, clearing house-related processes.

Consultation Option

1. if your product is in java, then we are very close. You can buy my java Spring Boot API Service source code which converts JSON to EDI and vice versa.

1. JSON to EDI 270 Eligibility and Benefit Inquiry
2. Create EDI 270 from JSON
   
3. Parse EDI 271 Message to Human Readable Text
4. JSON to EDI 837 Professional Claims
5. Parse EDI 837p Message into JSON
6. Parse EDI 835 Message into JSON   
7. Parse EDI 835 Message to PDF
8. JSON to cms 1500 Form
9. Parse EDI 837p To HTML
10. JSON To EDI 837 Institutional
11. Parse EDI 837I to JSON
12. Parse EDI 837 Institutional To HTML
13. Create CMS 1500 Form using JSON
14. Parse EDI 837p to CMS 1500 Form

Here is the demo link
https://demo.nagatabilling.com/NagataEDITool/login.zhtml 

2. if your product in different technology, then I will help your developer to create an EDI file using Pseudo.  Here is a sample Pseudocode 

 For more detailed resume and skills, please refer to the following link

·       Online Resume

·       Linked Profile

My Email ID :  vbsenthilinnet@gmail.com
Mobile : (91)  95351 609 48  (India)