8 Replies Latest reply on Jun 15, 2013 4:36 PM by emr_doc

    Filemaker pro for Medical purposes

    nolak37

      Title

      Filemaker pro for Medical purposes

      Post

      Hello,

      I have created a database that holds patient information for a small medical clinic, this allows them to record patient visits and billing and uses the seedcode calendar for appointments, everything has been working fine until I was asked to look for a solution to send the information to the insurance company electronically instead of printing out and snail mailing the hcfa 1500 claim form. Has anyone found a way to transfer medical information using filemaker, when I called the Insurance company they required me to use HL7 standard used by the medical field but im not farmiliar with the language.

      I found this interface but im not sure how well it would integrate and its a bit expensive.

      http://www.interfaceware.com/chameleon.html

      Any help would be greatly appreciated.

        • 1. Re: Filemaker pro for Medical purposes
          philmodjunk

          If you have a form that you print out, you can also save it as a PDF and Email it. That might be your first step towards more automation.

          • 2. Re: Filemaker pro for Medical purposes
            bumper

            HL7 is an absolute bear. The problem with products like you mentioned is that they can also take a lot of trial and error to "get it right" and it still may not work for every provider. I know that a couple of FM developers have rolled there own, but unless you plan to learn how to support it you would always be beholden to a third party to make any necessary changes. Instead I would suggest you look for an intermediary company to take your data, convert it and send it on the providers. The upside is they usually work for a smaller per piece fee and they will probably already have experience with your providers. 

            My 2¢

            • 3. Re: Filemaker pro for Medical purposes
              nolak37

              emailing a PDF is not a solution unfortunately since they have a DB of their own that needs the info, they dont want to have to re-type it to insert it. There is also the issue of secutity although I suppose the PDF can be made to require a Password to view.

              perhaps an intermediary company would have to be involved to get what we need, thanks guys.

              • 4. Re: Filemaker pro for Medical purposes
                doct

                I'm in the process of doing the same thing. I would appreciate it if you (or anyone else on the forum) would be willing to share some your experience.  I'm looking at using Seedcode for scheduling and will also be having to deal with insurances. I'm researching this out and will advise if I find anything. The other option is using a clearinghouse and their software - which does mean another program for the staff to learn.

                • 5. Re: Filemaker pro for Medical purposes
                  bumper

                  Since you are doing insurance I am guessing that the solution requires HIPAA compliance. Unless you are up to speed on the regs you may want to search for a copy of Heather McCue's white paper. I believe it is still on FileMakers site. It may a little long in the tooth but it will give you a starting point. Then get up to speed on security. My suggestion is you hire a consultant to "harden" your network, because staff will be using the internet (sometimes even to get work done!) also consider buying one of the audit plug-ins to track field changes and deletions, World Sync and CNS are both reliable. As far as the insurance filing goes, I would google and re-google. Try to talk to as many providers as you can as well as the clearinghouses. See if they have anyone in your area that you can talk to about their service. Also are you going to be using them for filing only or also to handle the payments?

                  These are just some points to think about and not meant to scare you. FileMaker is an excellent tool for this purpose and is very flexible and forgiving. It is capable of recovering from just about and wrong turn you can make. One last thought. There are a couple of physicians and developers who have rolled their own in FileMaker. I know one, CottageMed, is freeware and I know one or two handled insurance, you might get some ideas from their efforts. 

                  HTH

                  • 6. Re: Filemaker pro for Medical purposes
                    nolak37

                    Check out officeally.com, they are a large clearinghouse with experience working with custom filemaker EMR.

                    • 7. Re: Filemaker pro for Medical purposes
                      jamroman

                      Does anyone have experience with Iguana or Mirth hl7 connectivity with filemaker?  I am starting to tinker with each and was hoping to get some opinions before getting too involved with the products.

                       

                      Thanks,

                      James

                      • 8. Re: Filemaker pro for Medical purposes
                        emr_doc

                             I am a physician that has some knowledge of filemaker and am searching electronic billing.

                             I will post here my understanding please correct me if i went wrong.

                             Sending the claims in PDF files to the payer does not do it since they will not take the effort to put the info in the proper format that matches their end of the map.

                             837 professional is the format of electronic billing that deals with small/solo office practice and it is the HCFA form info in a dizzying map.

                             There are many third party softwere that has that done like in BIZTALK, IBM WEBSPHERE....etc that deals with EDI and has the package for HCFA forms.

                             It would be nice to have a solution in filemaker that will address that. created by filemaker developers instead of going to a foreign party since filemaker meets HIPAA security requirements and there is a nice paper about that that i linke to it:

                             "FILEMAKER and HIPAA  A TOOL FOR COMPLIANCE"

                             http://www.filemaker.com/downloads/pdf/filemaker_and_hipaa.pdf

                             The idea revolves around exporting the records of HCFA to a flat data file in certain format that meets the regulations of the industry if you are going into batch file submittin, real time submitting is not yet met by all the payers some though have the ability to do it.

                             In theory you should be able to make your solution and test it with the payer then you fine tweak the mistakes, if you are not using a clearing house then you should tailor your solution to every payer since there may be some differences from the general industry guidlines indicated in the implemetation guide of 837p (p stands for professional which is small practices and not hospitals or dentists).

                             I am working on developing something to that effect i will be more than glad to share the idea with any one who is interested and get any correction for what am in the process of doing. if then the idea deemed not worth continuing then be it, will go to a third party.