related causes not showing up on claim

[hrw911]

I am using rev management in v.17 sp.1 to send claims (4010). When a condition is related to work comp, I am checking the "Employment related" box in the case, but the CLM*11 field is not populating with "EM" in the 4010. Any ideas on how to fix this?

[Gavin Walker]

The Injury/Illness/LMP Date must also be filled in in MMDDYYYY format.

[hrw911]

The dates are filled in for these claims. Still no "EM".

[Gavin Walker]

OK, one of the following must also be true:

Accident -> Related To = Auto or Yes

Or

Accident -> Nature Of = "Injured At Home" or "Injured At School" or "Injured During Recreation"

[hrw911]

If I select Accident, related to as "Yes", it populates with "OA" rather than "EM" (even if I also have related to employment checked). It would not be appropriate to indicate that patient was injured at home, at school, or during recreation for a work comp/related injury. I also tried selecting "work injury/non-collision" with "related to employment" and no accident indicator populated the claim.

[hrw911]

Also, I did try selecting all of these 9even though they are not appropriate for actual billing) in combination with "related to employment", and no accident indicator populated the claim at all:

Accident -> Nature Of = "Injured At Home" or "Injured At School" or "Injured During Recreation"

Selecting "related to accident' as "yes" gives you an "OA" indicator no matter what other boxes you check or select.

I couldn't find any combinations of any indicators to get an "EM" to populate on the claim.

[Gavin Walker]

I see what you mean. The combination of checkboxes to indicate "related to employment" are contradictory.

Do this:

1. Blank out Accident -> Related To
2. Set Accident -> Nature of to "Injured during Recreation"
3. Check Employment Related

Let me know if that works.

[Gavin Walker]

Oh, one more thing, insurance type cannot be "Medicaid". I am not sure why that is.

[hrw911]

No, that did not work (there was no indicator at all), and the insurance type is not Medicaid.

[Gavin Walker]

I see there is code to produce an EM, but the logic is so messed up I can't find a combination of options to produce the EM in CLM field 11.

Until McKesson can fix this, you will need to create a custom IGuide or work with someone who can help you do this.