The greatest disadvantage of electronic claims is that they are near impossible to understand in raw form. Storing an image associated with a claim makes a lot of sense for the most HIPAA Claim Master's users. If you have an investment in a claim imaging system, you can now create images from EDI files and treat them in your imaging system just like scanned images from paper claims. If your staff can understand a claim on a UB04 in a second, why not make it available in this form? Having an image file makes it possible for case workers to call up an image of the claim in seconds.

The HIPAA Claim Master can also be used to create image files and PDFs of the EDI claims. Image file creation is a component that can be licensed separately.

The HIPAA Claim Master displays the EDI document in a page that makes it easy to read the 837 transactions. The following formats are supported:

Note: Earlier versions of the HIPAA Claim Master used a third party image printer driver. This is no longer necessary. The HIPAA Claim Master now has PDF and TIFF capabilities built-in.

Certain parameters of the formats are adjustable.

This is the same information that is in the image index files. This small subset of the claim data plus the image path and filename serves most image libraries well.

Image filename is also exported to the claim export. Here, we can also associate an image filename with the more complete claim data.

You can create image files containing the data that you see in Screen mode. You can create image files manually or automatically using the command line arguments and Windows Scheduler. Read more in:

Before creating image files, make sure all settings are defined correctly. Read more in:

How to Create Image Files

Follow the instructions below to create an image file from EDI file.

Notice: The image file will be created based on the pre-defined settings. Read more in Doing Image Setup, Configuring Image Index.

Before proceeding with image export, do the image setup as described further.

Select Image Image File Options in the main menu to access the "Image File Options" window.

The "Image File Options" menu

The following window will appear:

The "Image File Options" window

You can set the parameters for image file creation; they are described below.

Once the options have been set, click "Save."

Image File Options

You can create a hierarchy that determines which ID will be used for the filename. In the picture below, you see that the document control number (REF*F8) is the preferred filename. If such a segment is not present then the second option is the Clearing house ID, third is the Medical record number. Since none of these segments are mandatory, you might encounter claims that do not produce an image name. We strongly recommend to also use the Provider's Claim ID (CLM_01) as a fall back option in the naming of the image files.Your choice will then be stored in the Windows registry.

The image naming hierarchy

To prevent the overwriting of existing image files, the HIPAA Claim Master checks if a file with that name already exists and starts to append enumerations to the filename. For example, WD34222_3.pdf would be the 4th instance of a file with WD34222 as the Claim ID.

Image Format

Choose either PDF or TIFF. These are the two most widely used image formats. TIFF (Tagged Image File Format), historically derived from Telefax technology, has not been updated since 1992. PDF (Portable Document Format) has been the open standard since 2008 and has become very popular, due to the ease of the format.

Print Additional Pages

This option determines whether the additional pages with either COB information or segments with additional information that have no representation on the standard forms, should be printed on either paper or image files. This option helps you save paper. If you only need the main claim form, there is no need to create a multi-page image file with 2 extra pages.

Image Folder Options

When you create image files of claims, you could soon end up with thousands of images in one folder. Windows has real problems with folders containing more than 1,000 files. For this reason, the HIPAA Claim Master can hash the images over many folders to make sure that file quantities per folder remain low.

Folder Options Year, Month and Day

You can see that there is a folder with the year 2010 under the Output directory, then subdirectories with the Month which are, finally, further subdivided into days of the moth. The 2010/September/1 folder contains all the images created that day.

Document Color on Images

This section of the setup window is concerned with the output colors. The form background can be set to red to make the form more visually appealing and to allow the use of a color filter for OCR software.

Options for PDF

Options for TIFF

Here you can adjust the settings of the Image files.

Note: TIFF in Window's GDI library does not work with 16 bpp (bits per pixel). Color depths set lower then 16 bpp results in some losses in image quality.

Reference: The black-and-white (bi-level) image means that for each pixel (picture element) in the image we do not need three bytes as in the true color image (over 16.7 million colours), but only one bit that is 1/24 part of the pixel size from the true colour image. The one-bit pixel can express only black or white colors, nothing more.

Note: Theoretically we could use even higher resolutions, but it will slow down processing significantly result in approximately the same result in quality.

Many of HIPAAsuite's clients have Document Management Systems into which they scan paper claims. Often the whole claim department is built around this imaging system. With the prevalence of electronic claims, the need arises to create images of the EDI claims as well. This is the whole reason behind the HIPAA Claim Master. These images had to be imported with associated indexes into the document management system. The image index capability was added for two different clients:

Both of these solutions are now part of the HIPAA Claim Master and most of our other products.

Select Image Image Index File Options in the main menu to access the "Image Index Configuration" window.

The "Image Index File Options" menu

You can define which fields to include and configure your database settings. Here are all options:

Create Image Index

Check this option to create the image index. Select one of the following options to specify the format:

In the "Text File with Image Files Path" field specify the output directory for image index. Click "Browse" to select the destination place.

Note: The image index ASCII file currently works only when you save individual images for each claim.

The "ASCII Text File" option

Then click "Save."

The "Database Export" option

Once all database connection parameters have been specified, click "Test Connection" to verify the connection.

The "Test Connection" button

The configuration is correct if you receive a message like this. Click "OK."

The success message

Then click "Save Database Connection."

The "Save Database Connection" button

To create the image index table, click on the "You can create the Image Index Table through a separate screen." See Creating Image Index Table.

Selecting Fields to Be Included to the Image Index File

You can select the fields that get imported into the image index by selecting the check-boxes in front of the field names.

The fields to be included in Image Index File

Tip: As with the other field selectors, you can change the field names by clicking twice on them. This is helpful if you have an existing database that you want to access with different names.

Changing the field names

For Database export, you can test the fields configuration by clicking on the "Test Field Configuration" button.

The "Test Field Configuration" button

You will receive a message like this. Click "OK."

The success message

When ready, click on the "Save Field Configuration" button.

The "Save Field Configuration" button

Once all image index options have been defined and saved, click "Close."

The "Close" button

To create the table for the image index, follow the instructions below.

4. Then make sure the image index table script is correct.

 

The "Create Image Index Table" window with the "Microsoft SQL Server" option selected


The "Create Image Index Table" window with the "MySQL/Generic" option selected

5. Click on the "Execute Script" button.

 

The "Execute Script" button

Then you will receive a notification like this. Click "OK."

The success message

6. Then click "Save."

 

Example

You can use the following MySQL/SQL script:

 

CREATE TABLE `edi_837imageindex`(

  `ID` bigint(20) NOT NULL AUTO_INCREMENT,

  `EDIFilename` varchar(100) DEFAULT NULL,

  `ImageFilename` varchar(100) DEFAULT NULL,

  `ClaimNo` varchar(35) DEFAULT NULL,

  `TradingPartnerID` char(15) DEFAULT NULL,

  `ReceiveDate` date DEFAULT NULL,

  `BillProvID` varchar(80) DEFAULT NULL,

  `BillProvLast` varchar(55) DEFAULT NULL,

  `BillProvFirst` varchar(35) DEFAULT NULL,

  `SubscriberID` varchar(15) DEFAULT NULL,

  `SubscriberLast` varchar(55) DEFAULT NULL,

  `SubscriberFirst` varchar(35) DEFAULT NULL,

  `SubscriberMiddle` varchar(25) DEFAULT NULL,

  `PatientID` varchar(15) DEFAULT NULL,

  `PatientLast` varchar(55) DEFAULT NULL,

  `PatientFirst` varchar(35) DEFAULT NULL,

  `PatientMiddle` varchar(25) DEFAULT NULL,

  `PatientDOB` varchar(50) DEFAULT NULL,

  `PatientSex` char(1) DEFAULT NULL,

  `Amount` decimal(10, 2) DEFAULT NULL,

  `ServiceDateFrom` date DEFAULT NULL,

  `ServiceDateTo` date DEFAULT NULL,

  `ClearingHouseID` varchar(100) DEFAULT NULL,

  `OrigRefNo` varchar(50) DEFAULT NULL,

UNIQUE KEY `ID` (`ID`)

) ENGINE=InnoDB AUTO_INCREMENT=6 DEFAULT CHARSET=latin1;

 

 

Tip: Make sure you use a correct symbol ` and not ' in the script.

 

Tip: If you encounter errors running the script on MySQL or other database systems, then modify it until it works or consult with your database administrator to make the modifications. SQL Scripts share over all platforms a lot of syntax, but still each flavor demands its own adjustments.

 

Tip: If you encounter persistent errors with the script, we recommend working with the scripts within the database environment. SQL Server Enterprise Manager or SQLyog, for example, have an SQL query analyzer that helps you tweak the script until it runs.

 

The HIPAA Claim Master has a built-in image viewer that uses light weight dll's to display TIFF and PDF images. It also allows you to navigate through the folder structure that has been set up.

Select Image  Image Viewer in the main menu to access the "Image Viewer" window.

The "Image Viewer" menu

The following window will appear:

The "Image Viewer" window

The Viewer lets you navigate through multi-page documents with the navigation buttons in the upper left corner of the image. You can adjust the display size according to your monitor size or preferences in the upper right corner.

The left panel lists all generated TIFF and PDF files. Click a file name to display its content.

TIFF: Microsoft Windows has a Windows Photo Viewer that renders TIFF images. Unfortunately, it is not that practical. It omits lines in lower magnification and makes the image look sloppy, but is sufficient for most. There are much better TIFF viewers out there but we will not make any recommendations.

PDF: PDF files can be opened with Acrobat Reader by Adobe, which is available for free. There are also other free PDF viewers and editors. We will not make any recommendations.