Chargeable Flag, Patient Chargeable

Hi,

We are working on mapping our patient chargeable flag within IC12 to our Epic interface via a flat file upload into a clinical bridge interface that then converts the information into an HL7 format for Epic to receive and discern for processing.

We have run into an issue where the chargeable flag is set to "Y" within IC12, but when we look at the flat file being sent through the clinical bridge interface, it is sending through a "N" value. Does anyone have any insight as to what we might be missing that would cause this to happen? Please let me know if you would like further clarification on the situation.

Thanks
John

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Legacy Contributor

John:
We use an HL7 interface from Lawson to Cerner. The chargeable flag has to be the same in two places for ours to process correctly. It has to be set in IC12 and the IC81 par location.

We use IC527 - though that is only one of several that you can use. I ran into your same problem until I figured out the combination of IC12 and IC81. Try that and see if it helps.
Vicky

Legacy Contributor

We discovered that Epic had told our cloverleaf to hardcode the value. You may want to have them check that they aren't populating it on their own.

Legacy Contributor

John: In the output of our HL7 file before it goes over to Cloverleaf or to Cerner, we can see the chargeable flag as Yes. The flag is found in the CD3 segment on IC527 to the left of the long number: Y|000000008.0000

CD1||213777^SNSR OXM LNCS TC-1 3FT LF EAR|213777^SNSR OXM LNCS TC-1 3FT LF EAR 1EA/BX|SNSR OXM LNCS TC-1 3FT LF EAR 1EA/BX||||||||||||||||
CD2||213777^SNSR OXM LNCS TC-1 3FT LF EAR|213777^SNSR OXM LNCS TC-1 3FT LF EAR 1EA/BX|EA|1.000|BX|1.000|||||MASM^^MASIMO|1895|625^CARDINAL HEALTH|MASI1895A|120.49||||||||||||||BX|||||
CD3 ||213777^SNSR OXM LNCS TC-1 3FT LF EAR|213777^SNSR OXM LNCS TC-1 3FT LF EAR 1EA/BX|SANES|AE02A16|006410^0000|BX|BX|||||||||||Y|000000008.0000|N|||||||||A

Then we have Cloverleaf break out the flat file into two files, one with chargeable items, and one with non chargeable items. Each of those files are sent to Cerner at different times. This second piece can be managed different ways.

Vicky

Legacy Contributor

Thanks for all of the responses. Since we are an Epic client, we are using the IC524 flat file dump that is sent through our clinical bridge interface. Once there, it is traslated into an HL7 script then fed to Lawson.

I think the issue was we didn't have the flag in IC81 set to "Y", we are testing this now.

Again, thank you for the feedback. It was very helpful!
John

Legacy Contributor

Sorry, the information is sent form Lawson to the clinical bridge, then translated to HL7 and sent to EPIC not Lawson... sorry :-)

Legacy Contributor

Curious why the flag needs to be set on IC81? We don't have our main OR inventory on PAR, just in IC12 as non-tracked with allow receipts and issues set to N.
We run the IC527 and pass off to bridges interface. We don't currently send patient charge information, but are looking to soon. I had tested sending the patient charge information (PC10) and price and that worked, but I didn't specifically look at the Chargeable Flag so will have to retest.

Legacy Contributor

Just went back and looked, and I see the chargeable flag is "Y" on the IC527 output. Again, we don't have this set up on IC81, we are on 9.0.1.9 apps

Legacy Contributor

Hey,

I'm guessing that since you do not have your locations setup as Par locations within Lawson, the IC81 flag will not matter. We had decided to setup additional locations in IC81 so that when that informaton was transitioned into Epic, we would be able to apply charges and have those charges associated to the appropriate cost center.

We did not notice the charge flag in the IC81 screen until Vicky mentioned that in her response yesterday. I believe that fixed our issue, but still waiting for our Epic interface team to confirm the information crossed correctly.

Thanks again for all the responses
John

Legacy Contributor

We do have our surgery locations setup as par. And those specific pars are setup in a group. That grouping is defined on IC527, so only those locations and items are sent on the interface. So yes, John, that is why we had to have both the IC12 and IC81 set the same. We do not use the PC setups, like darringt said they use, so I wonder if they work differently.

I don't know how Epic works compared to Cerner, so this may be different. But Cloverleaf checks that flag and separates the chargeable items into one file, and the non-chargeable items into another file. The chargeable file is sent to Cerner at 12 midnight, and something on the Cerner side processes the items as chargeable into their system. The non chargeable file is sent to Cerner around 1 am, and again something on the Cerner side processes those items as non chargeable. Sorry, which I could be more clear, but it is the Cerner opsjobs that do the processing into their system.

We are on 9.0.10 apps.

Vicky

Legacy Contributor

darringt - I was rereading your response. Maybe if you don't have these items on a par (IC81) and only on IC12, then that is the only place you need the flag set. But if you have them setup in both places, maybe then you have to have the chargeable flag as Yes in both. Now you have made me curious.

Vicky

Legacy Contributor

Vicky - I believe that's what was causing issues for us. Since we have those loaded in IC81, we had to update the flag in IC12 and in IC81. We are waiting for our interface team to push the file through so we can verify that was the fix we needed.

I'd be more than happy to post the testing results if anyone's interested.
John

jreese

I believe in one of the 9.0.1 MSP upgrades we discovered that we needed to update the IC81 flags to match the IC12 Chargeable flags in order for the data to pass over to MSCM. I do not remember it having an effect on the IC527 program. Perhaps the IC524 process uses the same logic used to determine what is passed over to MSCM and that is why you might find you need to keep both flags in sync. Nothing in Lawson alerts you if the flags are different so we created a Smart Notification to send an alert each day of any items where the flags are different.

Legacy Contributor

Hi,

Our test results confirmed that if a product is flagged as chargeable in IC12, and is loaded to a par location in IC81, it must be flagged as chargeable in the par location as well. Our Epic team was able to confirm the charge flag reutrned as yes within the Epic interface.

Thanks for the help!
John

Legacy Contributor

JReese.... that is a great idea. I will have to borrow it.
John... glad I was able to help. I have spent a lot of time testing and validating the processing of our interface, with the initial implementation and then again with code upgrade in Cerner. But I am not an expert, by no means.

Vicky

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