From: John M Miller <jmmiller@msms.org>
Date: January 8, 2007 4:49:09 PM GMT-05:00
To: goldenmouse@columbus.rr.com
Subject: Re: EDI and Medicaid
On Jan 8, 2007, at 1:19 PM, goldenmouse@columbus.rr.com wrote:
Now, I'm helping a local medical practice set up its own Medicaid
billing. The process, near as I can tell, runs like this: Submit
Medicaid claims via EDI (format comparable to XML) to their servers,
then receive, each week, a receipt for those claims as well as a
direct deposit. What I'm looking for is software that manages this,
preferably licensed under the GPL.
Dear Goldenmouse,
I am afraid you are tackling a pretty big problem. The waning days
of the Clinton
administration presented the business of medicine with a rather
large gift in the
form of HIPAA. Unfortunately The CPT codes are nothing like XML
and completely
incompatible with the GPL.
Remember that Ross Perot's second company is currently talking
about providing
free software (free as in "beer" and not as in "speech") for
practice management
in order to get a bigger market share of the service bureau pie.
Ross Perot built
his first company processing Medicare claims.
Also remember the CPT codes are owned by the AMA. The AMA may be
second only
to the trial lawyers in lobbying. The revenue from CPT licensing
fees, in recent years,
has been larger than the amount collected from member dues.
I have been thinking about gathering together 20 or 30 old friends
and making
a set of procedure codes from scratch, all contributed from actual
practitioners.
XML would be a fine vehicle. I have been procrastinating for
almost 6 years now.
Perhaps your question will turn up more people with an interest.
Regards,
John M. Miller M.D.