New modules for OpenMRS and OpenIMIS from SolDevelo

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As you probably know, SolDevelo has built new modules for OpenMRS side and new functions for OpenIMIS as a part of a Digital Square project - Notice C1 which includes Develop a claim submission, enrollment, and enrollment verification module with a clinical point of service application using the relevant HL7 FHIR standards. The project started last year and now modules are ready to be tested and launched for the audience

In short, the module is responsible for checking patient insurance enrollment on registration (in external Insurance Management Information System) status and submitting claims (managing patient billing). Maybe the picture shows you how it works. More information you can find here: https://applications.digitalsquare.io/notice-c/concept-note/55 and on our website: https://soldevelofoundation.org/new-modules-for-openmrs-and-openimis/

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A few questions:

  • Does this work with insurance clearing houses?
  • Which standard insurance claim forms were followed (if any)? (e.g. US standard insurance claim forms are: CMS- 1450 for hospitals/facilities and CMS-1500 for individual practices)
    • Can this be used at a hospital/facility and/or individual practices (i.e doctor’s office)?

Thanks,

John

@zuzanna , well done for the great work .
Are we talking about several modules or a single module , you seem not to be clear in your post .

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Hi @jesplana,

openIMIS is geared towards health protection scheme operators (eg. health insurance) - they would host the instance of openIMIS and hospitals/facility or individual practices (who are registered with the scheme operator) can submit claims electronically.

openIMIS has its own web-interface for submitting claims (see attached annotated picture), or now can even accept claims electronically from a OpenMRS and Bahmni.

As for form itself, it isn’t based on any particular standard from a country as the requirements differ quite a bit. The claim form in the attachment should give you an indication of the information being collected in a claim.

More information on openIMIS on our website: www.openimis.org and wiki: wiki.openimis.org

Feel free to reach out if you need further information!

Thanks,

Saurav

openIMIS Initiative

Hi @zuzanna / @sbhattarai,

How does this relate to the work done by Possible Health (see here)?

While I’m happy to see groups investing in cross-system integrations, I find it always a bit of a misuse of resources to see pretty much the same thing being done twice (at the same time). Especially when claim management is not quite the top priority for so many OpenMRS implementations out there… I feel like a simple “market research” around the OpenMRS/Bahmni community would have created a possible synergy rather than a double set of solutions.

I know, the Bahmni one involves some kind of ERP linkage, but that should not be a show stopper either, or is it too late to “merge” and help create a wider community of development around a single OpenMRS-openIMIS solution?

Cc @suruchi @laxman

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Also, SolDevelo writes another article about modules and it’s great: https://www.blog.soldevelo.com/openimis-insurance-claim-module/ You find there some infos about the background, gole and the whole process.

Hi @mksd,

that is a very valid input - I fully agree. In fact, this activity was part of a larger development project to re-architecture openIMIS and to provide interoperability options into the OpenHIE architecture, notably FHIR compatible APIs. The teams working on the BAHMNI and OpenMRS integrations actually integrated each others work. Find out more about the respective projects in our wiki:

In the openIMIS Initative we strongly believe in the community approach. There is an Implementer’s community and a Developer’s community and we expect each of the teams we contract to join the weekly/monthly calls and to participate in community workshops. Independent developers are highly recommended to join in, if they want - we are very open.

Personally I had a great time with the FHIR-Teams - that was a very productive project with a strong spirit of helping each other.

Best regards - Uwe

For your convenience let me also give you the links to the respective communities: