SOLUTION

FORMAT

DATA ELEMENTS

ALL

CSV

Patient Demographics:

• Patient ID
• Active
• Chart | Preferred Name | First Name | Middle Name | Last Name | Date of Birth | Gender | Address 1 | Address 2 | City | State | Zip Code | Home Phone | Cell Phone | Work Phone | Other Phone | Email Address | Preferred Provider

EHR

PDFs with Index File

Signed Legacy Encounters

EHR

PDFs with Index File

Signed Smart Form Encounters

EHR

Uploaded File Type

Generated PDF Files

ERX

CSV

Prescriptions:

First Name | Last Name | Date of Birth | Prescription Entry Date | Prescription Void Comments | Drug Name | Dosage | Quantity | Unit Type | Drug Version

BILLING

CSV

Cases (Patient Level Insurance):

Patient Name | Case Name | Case Description | Status | External Case Id | Patient Condition Related To | Referring Provider Information | Case Payers | Prior Authorization Details | Guarantor Name | Guarantor Relationship | Case Dates

BILLING

CSV

Payers:

Name | NPI | EIN | Address1 | Address2 | City | State | Zip Code | Phone | Electronic ID | Real-time Tran Electronic ID | Eligibility Electronic ID | UBO4 Claim Electronic ID | UBO4 ERA Electronic ID

SOLUTION

FORMAT

DATA ELEMENTS (columns in the export file)

EHR

CSV

Current Meds (Plugin Data):

Drug Name | Dosage | Qty/Dur | Refills | NDC | Rx Norm Code | Last Rx | Start Date | Source | Added By | Last Modified Date | Notes

EHR

CSV

Med History (Plugin Data):

Problem | ICD10 | ICD9 | Source | Date Recorded | Status

EHR

CSV

Allergies (Plugin Data):

Allergy Description | Rx Norm Code | Reaction | Severity | Comments | Is Active | Date Added | Last Modified Date | Record Source

EHR

CSV

Vitals (Plugin Data):

Age | Entry Date | Record Date | Added By | Weight | Temperature | Heart Rate | Height | O2 Saturation | BMI | Respiration | FiO2 | Head Circumference | Glucose | BP Systolic (Sitting) | BP Diastolic (Sitting) | Location (Sitting) | Pulse (Sitting) | Rhythm (Sitting) | BP Systolic (Standing) | BP Diastolic (Standing) | Location (Standing) | Pulse (Standing) | Rhythm (Standing) | BP Systolic (Supine) | BP Diastolic (Supine) | Location (Supine) | Pulse (Supine) | Rhythm (Supine) | Comments | Encounter ID | Encounter Date

EHR

CSV

Patient Procedures (Plugin Data):

Code | Description | Date Performed From | Date Performed To | Performed By | Type | Status

EHR

CSV

Patient Diagnosis (Plugin Data):

Description | ICD10 | ICD9 | SNOMED | Onset Date | Status | Status Date | Type | Date Diagnosed | Last Modified Date | Severity

EHR

CSV

Patient Notes (Plugin Data):

Date | Added By | Notes

EHR

CSV

PFHS/Social History (Plugin Data):

Social data | Psychological data | Behavioral data

EHR

CSV

PFHS Social Hx – Smoking Status (Plugin Data):

Smoking Status | Start Date | End Date

EHR

CSV

PFHS – Family History (Plugin Data):

Family Member | Problem | ICD10 | ICD9 | Source | Date Recorded | Status

EHR

CSV

Immunizations (Plugin Data):

Name | Type | Active | Date Administered | Expiration Date | Funding Source | Administered By | Unit | Site | Vaccine Route | Lot Number | Manufacturer | Dose | VFC Screening | VIS Given Date | VIS Upload Date | Remarks

SCHEDULER

CSV

Appointment Data:

Appointment ID | Patient Name | Date of Birth | Created By | Doctor Group Name | Case ID | Check In Time | Call In Time | Check Out Time | Duration Minutes | Start Date Time | End Date Time | Active | Status Code | Series Code | Series Description | Repeat Count | Preferred Number | Referring Provider | NPI | Phone | Patient Active | Chart Number

BILLING

CSV

Patient Charges:

Patient Name | Encounter ID | External Encounter ID | Claim Form Type | Active/Inactive | Case Name | Service Date | Service Date To | External Signed Date | Rendering Provider | Billing Provider | Scheduling Provider | Referring Provider | Supervising Provider | Attending Provider | Operating Physician | Other Operating Physician | Service Facility Location | Status | Prior Authorization Number | Primary Insurance | Payment Responsible Party | EPSDT | EPSDT Condition Indicator | Assignment Accepted | Ready To Bill Date | ICD Code Type | Submission Mode | Line Of Business | UB04 Location Type | Admission Type | Admission Source Code | Admission Date | Admission Hour | Discharge Hour | Discharge Status | Line Item Service Date | Line Item Service Date To | Line Item Active | Procedure Code | Revenue Code | Procedure Modifiers | Diagnosis Codes | Units | Charge Amount | Non-Covered Amount | Total Amount | Miscellaneous Charge Transaction Code | Misc. Fee Schedule | Misc. Unit | Misc. Amount | Misc. Charge Amount | Misc. Charge Comments | Misc. Charge Status | Encounter Dates | Occurrence Codes (UB04) | Condition Codes (UB04) | UB04 Diagnosis Codes | Value Codes (UB04) | Insurance Payments | Patient Payments

BILLING

CSV

Claims:

Patient ID | Encounter ID | RxNT Claim ID | Claim Created Date | Claim Sent Date | Claim Status | Active/Inactive | Claim Form Type | Payer | Priority | Claim Filling Method | Claim EDI | Clearing House Trace Number | Clearing House File Number | Payer Claim Reference

BILLING

CSV

Insurance Payments:

Insurance Payment ID | Insurance | Payment Method | Check/EFT Trace # | Payment Date | Status | Posted Date | Amount | Penalty Amount | Active/Inactive | Patient | Encounter Id | Line Item Payer | Rev/CPT Code | Payment Code | Charge Amount | Allowed Amount | Disallowed Amount | Coinsurance Amount | Copayment Amount | Deductible Amount | Other Patient Responsibility Amount | Payment Amount | Balance Amount | Write Off Amount | Adjustment Code | Adjustment Amount | Total Adjustment Amount | Leave Open | Misc. Payer | Misc. Payment Code | Misc. Reason Code | Misc. Amount | Misc. Comments | Misc. Status

BILLING

CSV

Patient Payments:

Patient Payment Id | Payment Method | Check/EFT # | Payment Date | Status | Posted Date | Amount | Active/Inactive | Patient | Encounter Id | Rev/CPT Code | Line Item Paid By | Payment Code | Charge Amount | Payment Amount | Balance Amount | Adjustment Code | Adjustment Amount | Total Adjustment Amount | Write Off Amount | Misc. Paid By | Miscellaneous Charge | Misc. Charge Amount | Misc. Payment Code | Misc. Payment Amount | Misc. Balance Amount | Misc. Adjustment Code | Misc. Adjustment Amount | Misc. Comments

BILLING

CSV

Patient Funds:

Patient | Amount | Transaction Type | Approved Status | Payment Type | Payment ID | Comments | Active/Inactive

EHR

JSON

Lab Results:

JSON File per patient

EHR

CSV

Lab Orders:

TestType | LabOrderId | TestName | Provider | OrderDetails | OrderDate | Diagnosis | Urgency | Status | AddedDate

BILLING

CSV

Fee Schedules:

Procedure Code | Fee Schedule Name | Fee | Expected Rate

BILLING

CSV

Favorite Diagnosis:

Diagnosis Code | Diagnosis Description | Diagnosis Type

BILLING

CSV

Favorite Procedure Codes:

Procedure Code | Procedure Description