Canadian E-claims

kderhami · Post by **kderhami** » Tue Dec 11, 2007 7:27 pm

Hi Gordon:

When are we going to revisit Canadian E-claims again? A definite answer will be much appreciated.

Post by **jordansparks** » Tue Dec 11, 2007 9:31 pm

I know this isn't what you will want to hear, and I know this will probably make you (understandably) mad as hell. But it's currently a low priority. I have to do what's best for the future of the company and Canadian e-claims just isn't it right now. Here's why.

Let's say there are approximately 12 pieces to the total e-claims puzzle, which would include e-claims, estimates, benefits, attachments, status, payments, reports, etc. In the US, we are allowed to implement any portion of that, and actually most software companies implement none of it, leaving it to third parties. We implement maybe 3 or 4 of the components of the US system, and we are gradually bringing more of it on board. Just this week, we will finally have a functional integrated attachments piece.

Now contrast this with Canada, where they require every single one of the 12 or so pieces to be fully 100% implemented, tested, and approved. It's simply unreasonable and unworkable. When we first started, we really had no idea that the Canadian government could possibly have their heads so far up their butts that they would instist on 100% complete functionality of all components before even simple claims could be sent. And the more pieces of the US system that we've worked on, the more overwhelming the Canadian counterpart has become.

It'll be a couple of years. I really am truly sorry.

kderhami · Post by **kderhami** » Sat Dec 15, 2007 6:46 pm

It is certainly unreasonable that canadian authorities are asking for this. Goverment incompetency is a world wide phenomenon, as I am sure you in the US also have experienced a fair share of it in many matters of even more importance.

Since 3.5 years ago when I joined this membership, I insisted to be a paying member, because I believe your idea of an open-licensed software is a brilliant way to make a perfect software for dentistry and I wanted to be a small part of it. As you may remember The E-claims issue was my first concern then and now. Since then tens of other Canadian and American software companies have been successful in getting certified for Canadian e-claims. Opendental, on the other hand, kept hoping that an "unknown" so called company will develop the Canadian E-claims for it very soon. After 2 years it became increasingly evident that this so called "company" is not serious in this matter so we embarked on doing this ourselves only to realize, one and half year later, that this is of "low priority". Meanwhile, we (my staff and I) have invested time, money and effort in making Opendental our choice.

So, I am not mad because you could not live up to your expectations but dissapointed that it has taken you so long to realize this. I maybe dissappointed in you but I am sure as hell mad at myself.

Jorgebon · Post by **Jorgebon** » Sun Dec 16, 2007 5:40 am

How about if you guys settle on a compromise. Maybe somebody in Jordan's team can work on a small part of the Canadian claims thing for each version that comes out. It would be good to have a goal for a certain date (or several smaller goals for various dates). This would show progress and the good folks in Canada can feel they aren't left out.
Jorge Bonilla, DMD

By the way, Kderhami, your web site is impressive!

creat0r · Post by **creat0r** » Fri Dec 21, 2007 12:48 am

Perhaps a workable solution will be for the practitioners up in CA to pool $ and develop this module. Split up the costs upon many and share the results and code development to further the open source development.

Just a thought

kderhami · Post by **kderhami** » Fri Dec 21, 2007 3:27 am

Thank you all for showing interest in the subject.By the way, I posted a reply to George 2 days ago, but for some reason it didn't appear. George I'll more than happy to tell you how easy it was to do a website that's very inexpensive. Just e-mail me.

As far as the e-claim goes, I had already suggested both your ideas 2 years ago and I am still willing to do my part to help out. i will be more than willing to help out in any shape or form to develop this e-claim.

Post by **jordansparks** » Fri Dec 21, 2007 6:21 am

I like the idea of chipping away at it with each version. It's just discouraging to me that nobody can see the impressive work that we've already done, and that this strategy will continue to result in no noticeable change to the end users. If I had to estimate, I'd say we are currently 50% done. I'll put it on the future versions page phrased in this manner.

tdong · Post by **tdong** » Fri Dec 21, 2007 6:22 am

If it is just add-on modules to OD, I am willing to give it a try on the coding but since it does effect the core of OD system as per Dr. Sparks. I am kinda sit and wait.

We do lots of integration with banks here at my company and I just don't understand why Canada make data exchange so hard ?.

Since my wife is used to paper claim ever since she associates and now open her own. Mailing isn't that bad but e claim would be much better.

Mifa · Post by **Mifa** » Fri Dec 21, 2007 9:59 pm

Since eClaims are mandatory for our business, we have had a one-way bridge between OD and Adstra PMP developed for us (frankly speaking, I would have gladly given this same money to help the development of Canadian eClaims in OD instead).

The bridge allows us to send patient and procedure information from OD to Adstra; the eClaims are then sent from Adstra, and our clients can know right away how much their insurance covers. We've been using it for a few months in production with OD 4.6. I plan to test it during the holidays with OD 5.4.

It's a work around that works for us. If anyone is interested let me know.

kderhami · Post by **kderhami** » Fri Dec 21, 2007 11:39 pm

Hi Mifa:

that's good news, I would love to learn more about the bridge to adsatra. Is it possible to buy the e-claim module in adsatra and bridge OD to this module to send e-claims for now until OD has developed it own Canadian e-claims module???

tdong · Post by **tdong** » Sat Dec 22, 2007 12:00 pm

Yes I am very interest

Mifa · Post by **Mifa** » Sat Dec 22, 2007 1:35 pm

The first step for you both is to check with Adstra if they still offer the eClaims as a stand alone (it's basically their full package with only the patients, insurance and cdanet functionalities activated). It's not for free of course, but it's still less expensive than the full package.

tdong · Post by **tdong** » Sat Dec 22, 2007 1:44 pm

Thanks I don't mind to pay for one computer with full license as long as we can still use OD as the main program and use the brigde for eclaim. This is the only option so far for Canada until another few years when OD is ready for eClaim in canada

They have an office next to where I work I will give them a visit

kderhami · Post by **kderhami** » Mon Dec 24, 2007 12:57 am

Last week, before you had to us about the e-claim bridge, I checked with them and they offered me e-claim portion for about 2500:-. I believe it was for 2 computers. So, yes they do offer the e-claim.What is the next step?

kderhami · Post by **kderhami** » Mon Dec 24, 2007 12:57 am

Last week, before you had told us about the e-claim bridge, I checked with them and they offered me e-claim portion for about 2500:-. I believe it was for 2 computers. So, yes they do offer the e-claim.What is the next step?

tdong · Post by **tdong** » Thu Dec 27, 2007 7:10 am

Nice kderhami, they didn't reply me yet but $2500 sound perfect

Mifa · Post by **Mifa** » Thu Dec 27, 2007 3:52 pm

Kderhami, Tdong, I will forward to you both the specs for the bridge so that you assess if it works for you. Unfortunately, I don't have it on my laptop, I will need to dig it up from a backup when I will be back in town next week.

kderhami · Post by **kderhami** » Sun Dec 30, 2007 1:30 am

Mifa: thanks a whole bunch. anxiously awaiting your return. By the way, happy new year to everyone.

tdong · Post by **tdong** » Mon Dec 31, 2007 7:02 am

Thanks Mifa.

Happy New Year everyone

By the way kderhami who did you contact from Astra ?

http://www.adstra.com/index.htm is this the correct site ?

Mifa · Post by **Mifa** » Sun Jan 06, 2008 11:08 am

KDherami, TDong, I've just sent you the specs via a private message. Since it's the first time I'm using PMs, let me know if you don't receive it.

tdong · Post by **tdong** » Sun Jan 06, 2008 1:03 pm

Thanks Mifa
I got the PM
Thanks for the clear explanation. Will wait for the rest of the info before I ask question.

kderhami · Post by **kderhami** » Mon Jan 07, 2008 1:57 am

Thank you mifa:
I'm not sure what the next step will be but I'll wait for your instructions.

kderhami · Post by **kderhami** » Mon Jan 07, 2008 2:01 am

Thank you mifa:
I'm not sure what the next step will be but I'll wait for your instructions.

Tom Opgenorth · Post by **Tom Opgenorth** » Sat Jan 12, 2008 3:26 pm

Hi.

I'm new to OpenDent. I've be programming in .NET since the beta 1 days, and have spent a tiny amount of time digging through the current code base (primarily v5.2). I am trying to help out a local dentist to get OpenDent up and running (under Linux mostly). One of the things I was asked about was Canadian e-claims.

If I may ask a couple of questions:

How much actual demand is there for Canadian e-claims?

Exactly what kind of technical challenges does one face trying to implement Canadian e-claims? A very broad/open ended question I know.

Post by **jordansparks** » Sat Jan 12, 2008 8:27 pm

You might look back through some previous discussions. It's very complicated. What it really comes down to in the end is that we would have to suspend all other development and focus solely on this feature for one to two months. That's a very expensive proposition for us. Most other features only take a few days. Sacrificing such a large number of competing features could set us back in other areas enough to seriously impact our ability to compete in the US market.

murmsk · Post by **murmsk** » Sat Jan 12, 2008 9:25 pm

I am a US user so it doesn't affect me other than the overall success of OD.

Having said that it seems to me Canada might be a ripe market for OD ... If there are only a few others who can submit they might jump at OD ? Maybe I am wrong ( I was once ) but I think it would be worth investing time so it is completed by the end of the year.

just my 2 cents

steve

Tom Opgenorth · Post by **Tom Opgenorth** » Sun Jan 13, 2008 2:48 pm

I'm Canadian (but not a dentist). If I could see enough demand for it, I'd consider taking a crack at implementing Canadian e-claims.

Last year I worked with one client integrating their EMR system with the provincial health care system, so I can appreciate how complicated this could be.

So, I guess if there are any Canadian users who what e-claims, this might be the time to speak up. Or, likewise, if anybody has started on e-claims could I'd like to know about it.

Post by **jordansparks** » Sun Jan 13, 2008 3:56 pm

We already dedicated well over a month to implementing Canadian e-claims. You will see extensive implementation throughout the source code. I would say we are maybe 60% done and yet nowhere close to completion.

Tom Opgenorth · Post by **Tom Opgenorth** » Sun Jan 13, 2008 6:47 pm

Good to hear. Do you have any tips as to where a fellow should start looking in the code?

Post by **jordansparks** » Sun Jan 13, 2008 9:17 pm

Maybe a text search on "canada".

Joseph · Post by **Joseph** » Tue Jan 15, 2008 9:40 am

creat0r wrote:Perhaps a workable solution will be for the practitioners up in CA to pool $ and develop this module. Split up the costs upon many and share the results and code development to further the open source development.

Just a thought

I would support this idea, if anybody is interested pls. contact me at syscon@interbaun.com or Tom Opgenorth.

#Joseph

kderhami · Post by **kderhami** » Fri Jan 18, 2008 1:05 am

Sure, depending on the cost, I have been saying this since 2 years ago.

tdong · Post by **tdong** » Sat Jan 19, 2008 11:02 am

sure same as kderhami

by the way so far I only know 3 people using OD in Canada.

Mifa · Post by **Mifa** » Sat Feb 02, 2008 12:56 pm

tdong, kdherami,

I'm (finally) ready to send you the bridge program. I could not find a way to attach a zip file to a private message in the forum, so could you both send me an email to mfabre@cp3int.com and I'll attach it to my reply.

westden99 · Post by **westden99** » Mon Mar 24, 2008 7:11 pm

Hello Mifa,

I am a Canadian dentist considering OD for a new practice from scratch. Can you tell me what I have to do to submit e-claims? Can you suggest digital sensors that integrate well with OD?

tdong · Post by **tdong** » Wed Mar 26, 2008 10:05 am

Well we are still seeing demonstration from ASTRA for eclaim and my wife still deciding.

We are using Kodak and our friend using Schnick from Patterson both works great with OD using bridge. and I think OD does integrate with one of the sensor don't remember which one but still has very limited functionalities still work great with bridge ask Dr.Sparks

Canadian Eclaim probably won't be available for another 5 years.

Before using OD consider this, you need to update Procedure Code price manually yearly. Send paper for claim. if eclaim is a must then use ASTRA with the bridge provide by Mifa (worst case is that you have to double enter for eclaim using Astra software). Cost $3000 for Astra

Other than that OD is great

westden99 · Post by **westden99** » Fri Apr 04, 2008 1:39 am

Thanks for information. Wondering how does one add the Canadian Procedure Codes?

tdong · Post by **tdong** » Fri Apr 04, 2008 10:24 am

well we ask our receptionist to enter one by one ?
update price is also enter one by one

unless ODA gives us those Procedure Code and Prices change on computer file format then I can write code to update that automatically. As for now they sent us a booklet every year. I will look into that this year

But luckily for you since I already have all the procedure codes and the pricings. And I don't mind to share that with you. OD allows xml export and import but you are still stuck with the price.

I think I sent Dr. Sparks a copy of blank database with Canadian Procedure Code entered with 2007 price list.

Anyway if you want a blank database with the current 2008 pricings then I can create one for you if and only if you decide to use OD since I don't want to wast my time for nothing

Joseph · Post by **Joseph** » Wed Apr 16, 2008 8:07 pm

kderhami wrote:Sure, depending on the cost, I have been saying this since 2 years ago.

I have "CDAnet Message Formats" for Canadian Dental E-Claims. If anybody wants to join me financially for Canadian E-claims please drop me an email at syscon@interbaun.com (as I don't check this forum very often and I don't receive any email reply notifications either).

As to cost I don't know what will it be I know the certification alone will be about 2K+ CAD plus the programming.
I'm not a programmer so we would need to outsource the programming. I was thinking of releasing the claim under GPL after we recover the cost.
The programing itself should be implemented as an add-on modules (I think) to retain compatibility with new OD versions.
I think Dr. Spark has mention 60% is done so I don't know what is better option, continue this project or start from the scratch. When I was talking to CDAnet they have mention it to implement E-Claim takes about 3-months of programming.

Regards,
Joseph

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