SQL_HIPAA PACKAGE

MANUAL

Document Version: Beta0.02 By: Joe Thielen

LICENSE/LEGAL STUFF
This software comes "AS-IS" with NO WARRANTIES expressed or implied. This software is free for all to use, copy, edit, and distribute. The authors of this package assume no fault for any damage caused by the use of this software.

This software is copyrighted, and has been placed under the GNU Public License. Please support the GNU and the free software community at www.gnu.org!!! See the file COPYING for details. Here is the distribution statement:

This program is free software: you can redistribute it and/or modify it under the terms of the GNU General Public LIcense as published by the Free Software Foundation; either Version 2 of the License, or (at your option) any later version.

SUMMARY
SQL_HIPAA is a software package which can take data exported from any other software package (capable of communicating with SQL databases) and create a HIPAA-compliant ANSI X12 837 Professional EDI file. The focus of SQL_HIPAA is on mental health care oriented agencies whose patients are entirely covered under Medicaid (SQL_HIPAA CANNOT HANDLE INSURANCE!!!). The system was designed with the Ohio MACSIS system in mind, however, I hope to expand its use to other systems as well, time permitting.

WHAT IT DOES, AND DOES NOT, DO
SQL_HIPAA is not a magic bullet. You cannot just dump all of your clinical records into it and expect it to churn out a perfect EDI file. That's just not going to happen. Your notes must already be using proper HIPAA codesets (procedure codes, modifier codes, etc...) and you must report proper HIPAA units and charges for each note. SQL_HIPAA basically takes this information and creates a properly formatted EDI file. There will be some effort involved in getting SQL_HIPAA to work with your package (basically exporting service line items, resident information, calculating proper units, calculating item charge, etc...).

VERSIONS/AUTHORS
There are two versions of SQL_HIPAA: SQL_HIPAA-PHP and SQL_HIPAA-Perl (This version is now DEFUCNT).

SQL_HIPAA-PHP is written in the PHP programming language and can be found at http://sqlhipaa.familyandyouth.org.
It's primary author is Joe Thielen <joe@joethielen.com>.

SQL_HIPAA-Perl (DEFUNCT) is written in the Perl programming language and can be found at http://sqlhipaa.sqlclinic.net.
It's primary author is Thomas Good <tomg@sqlclinic.net>.

BASIC USAGE
SQL_HIPAA uses five SQL tables to communicate with a software package. These tables may exist in a current database, or can be set up in a totally separate one. For an in-depth look at these tables, read the SQL_HIPAA Table Specs Guide. You can use the included file makedb to create the tables.
  • hipaa_to: Data sent from the softare package to SQL_HIPAA
  • hipaa_from: Data returned to the software package from SQL_HIPAA
  • hipaa_orginfo: Data regarding the agency, contacts, etc...
  • hipaa_resinfo: Demographic info regarding residents
  • hipaa_services: Billable line items
    • The bulk of the information goes into hipaa_services and hipaa_resinfo. For each resident you will bill for, there must be one, and only one, entry in hipaa_resinfo. Each resident should have a unique ID number. This number may be assigned by either the state or the agency, depending upon the locale. The service line items are linked to residents by means of the pri_id fields in both hipaa_resinfo and hipaa_services.

    The file sql_hipaa-vars.inc contains the setup information necessary for SQL_HIPAA to access your database. This includes the hostname the database is stored on, the name of the database to use, and a username and password.

    ERROR CODES
    You can find more information about error codes returned by SQL_HIPAA in the SQL_HIPAA Error Code Guide.