HL7 ADT-SIU Specifications 12

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Intellect™

HL7 MESSAGE SPECIFICATIONS

Included in this document is the Prime Clinical Systems, Inc., HL7 Messages specifications. We are capable of supplying ADT & SIU messages. The messages are located on the server under the folder ' \home\staff\hl7' for pick up by the requesting Vendor or sent via TCP/IP to your server.

***Clients who are on the cloud (hosted) must use TCP/IP and a VPN Tunnel must be installed by Prime Clinical Systems IT. The installation of the VPN Tunnel is billable to the client***

With regards to DFT messages, you will be asked to drop the files into a folder on our server (Home\Staff\Import).

If the HL7 Vendor has acquired direct access to the client's server via a Windows Username/Password and needs the Username/Password again for any reason, they must contact the client directly.

Note:

Specifications noted in this document are to be reviewed by the HL7 Vendor prior to any arrangements to the client setup. It is solely the responsibility of the HL7 Vendor to adhere to the specifications within this document.

As a result of Prime Clinical's debugging, at any time after the HL7 interface goes live, if we find that the issue is related to the HL7 Vendor, a fee will be charged to the client for time spent in excess of two hours.

***No customizations will be made available***

The structure of the Messages:

ADT	SIU	MFN
MSH	MSH	MSH
EVN	SCH	EVN
PID	NTE	STF

(v20/01) 1

PV1	PID	PRA
DG1	PV1	NOTE: The MFN is created when the UT/REFERRING is added/modified.
GT1	DG1
IN1	GT1
	IN1

MSH Segment Message Header

Seq	Field	Comment	Example
1	Field Separator	'\|'	\|
2	Encoding Characters	'^~\&'	^~\&
3	Sending Application	PCS	PYXISCC
4	Sending Facility
5	Receiving Applications	PCS	PYXISCC
6	Receiving Facility		PRIME
7	Date & Time	YYYYMMDDHHMM	200210131750
8	Security ST
9	Message Type	ADT, SIU	A04, A08, S12, S13, S14, S15, S26
10	Message Control ID
11	Processing ID
12	Version ID	HL7 version	2.3.1
13	Sequence Number
14	Continuation Pointer
15	Accept Ack Type
16	Application Ack Type
17	Country Code
18	Character Set
19	Principal Language
20	Alternate Character Set Handling Scheme
21	Conformance Statement ID

SCH Segment-Schedule Activity Information

1/14/2020 *New field added SCH 4

Seq	Field	Comment	Example
1	Appointment Sequence	Numeric	87660
2	Appointment Sequence	Numeric	87660
3	Occurrence Number
4	Appointment Continuations	Initial slot: A Continuation slot: C	Code is either A or C
5	Schedule ID	Same as Appointment Sequence	87660
6	Event Reason	Hard Coded appointment reason	“Appointment”
7	Appointment Reason	Appointment Description	Office Visit
8	Appointment Type	Appointment Description	Office Visit
9	Appointment Duration	Length of appointment (NM)	15 or 30

(v20/01) 2

10	Appointment Duration Units	Unit of time	M
11	Appointment Timing Quantity	Date and Time of Scheduled appointment. yyyymmddhhmmssmsms	^^^2012061510000000
12	Placer Contact Person
13	Placer Contact Phone Number
14	Placer Contact Address
15	Placer Contact Location
16	Filler Contact Person	User code. Person who made the change to the appointment, can be numeric or alpha. Depends on the practice	81 or AJB
17	Filler Contact Phone Number
18	Filler Contact Address
19	Filler Contact Location
20	Entered By Person	Person creating the appointment	81 or AJB
21	Entered By Phone Number
22	Entered By Location
23	Parent Placer Appointment ID
24	Parent Filler Appointment ID
25	Filler Status Code	Status of the appointment	Booked, Arrived, Rescheduled, Canceled, Deleted

PID SegmentPatient Identification

Seq	Field	Comment	Example
1	Set ID
2	Patient ID (External ID)	Medical record/Chart number from EMR	2448
3	Account Number	Account number from PM software, or '0' if no account number available	2419859
4	Alternate Patient ID
5	Patient's Name	Last^First^MI	Doe^John^L
6	Mother Maiden Name
7	Date of Birth	YYYYMMDD	19700604
8	Sex	'M'-'F'	M
9	Patient Alias
10	Race	Race Code	1760-8
11	Patient Address	# Street^City^state^Zip	123 easy St.^Pasadena^CA^91107
12	Cell/Mobile phone #		(222)222-2222
13	Phone number home/Email	Full^^^Email Address	(222) 222-2222^^^xxxxx@xxx.com
14	Phone number business
15	Language Patient	Patient's Primary Language	English
16	Marital Status		Self, Married, Divorced, Widow
17	Religion
18	Patient Account Number
19	SSN Number Patient	Regular Format	111-11-1111
20	Driver's License-Patient
21	Mothers Identifier
22	Ethnic Group	Ethnicity Code	2170-9
23	Birth Place
24	Multiple Birth Indicator
25	Birth Order
26	Citizenship

(v20/01) 3

27	Veteran's military Status
28	Nationality
29	Patient Death date/time
30	Patient Death indicator
31	Identity Unknown Indicator
32	Identity Reliability Code
33	Last Update Date/Time
34	Last Update Facility
35	Species Code
36	Breed Code
37	Strain
38	Production Class Code

PV1 Segment- Patient Visit

1/14/2020 * New field added PV1-9

Seq	Field	Comment	Example
1	Set ID PV1
2	Patient Class	Outpatient	O
3	Assigned Patient Location
4	Admission Type
5	Pre-Admit Number
6	Prior Patient Location
7	Appointment Doctor Note. This is ONLY populated when message is created from the appointment (SIU)	Code^Last^First^Middle^address^Ci ty^State^Zip	00138^Sainani^Tyvek^M^1 23 easy St.^Pasadena^CA^91107
8	Referring Doctor. This information is from the patient's registration screen.	Code^Last^First^Middle^address^Ci ty^State^Zip	00138^Sainani^Tyvek^M^1 23 easy St.^Pasadena^CA^91107
9	Billing Provider OSI	Code^Last^First^Title^	00138^Sainani^Tyvek^MD
10	Temporary Location
11	Pre-Admit test indicator
12	Re-Admission Indicator
13	Admit Source
14	Ambulatory Status
15	VIP Indicators
16	Admitting Doctors
17	Patient Type
18	Visit Number
19	Financial Class
20	Charge Price Indicator
21	Courtesy Code
22	Credit Rating
23	Contract Code
24	Contract Affective Date
25	Contract Amount
26	Contract Period
27	Interest Code
28	Transfer to Bad Debt Code
29	Transfer to Bad Debt Date
30	Bad debt Agency Code
31	Bad Debt Transfer Amount
32	Bad Debt Recovery Amount
33	Bad Debt Recovery Amount

(v20/01) 4

34	Delete Account Indicator
35	Delete Account Date
36	Discharge Disposition
37	Discharged to Location
38	Diet Type
39	Servicing Facility
40	Bed Status
41	Account Status
42	Pending Location
43	Prior Temporary Location
44	Admit Date/Time
45	Discharge Date/Time
46	Current Patient Balance
47	Total Charges
48	Total Adjustments
49	Total Payments
50	Alternate Visit ID
51	Visit Indicator
52	Other Healthcare Provider

Change 9/9/2019 - When a New Patient is imported from an outside Vendor, via ADT/DFT HL7 message and PV1-19 is a valid Intellect Category , the Patient Registration Category will be updated to the value in the PV1-19.

IN1 Segment

Seq	Field	Comment	Example
1	SET ID
2	Insurance Plan ID
3	Insurance Company ID
4	Insurance Company Name
5	Insurance Company Address
6	Insurance Co. Contact Person
7	Insurance Co Phone Number
8	Group Number
9	Group Name
10	Insured's Group Emp Name
11	Insured's Group Emp ID
12	Plan Effective Date
13	Plan Expiration Date
14	Authorization Information
15	Plan Type
16	Name of Insured	Insured's Name
17	Insured's Relationship to Patient	Self,Child,Spouse, Other
18	Insured's Date of Birth	Insured's DOB
19	Insured's Address	Insured's Address
20	Assignment of Benefits
21	Coordination of Benefits
22	Coord. of Ben. Priority
23	Notice of Admission Flag
24	Notice Of Admission Date
25	Report Of Eligibility Flag

(v20/01) 5

26	Report Of Eligibility Date
27	Release Information Code
28	Pre-Admit Cert (PAC)
29	Verification Date/Time
30	Verification By
31	Type Of Agreement Code
32	Billing Status
33	Lifetime Reserve Days
34	Delay Before L.R. Day
35	Company Plan Code
36	Subscriber/Policy Number
37	Policy Deductible
38	Policy Limit - Amount
39	Policy Limit - Days
40	Room Rate - Semi-Private
41	Room Rate - Private
42	Insured's Employment Status
43	Insured's Administrative Sex
44	Insured's Employer's Address
45	Verification Status
46	Prior Insurance Plan ID
47	Coverage Type
48	Home Phone
49	Cell Phone

DG1

Seq	Field	Comment	Example
1	SET ID
2	Diagnosis coding method		ICD9
3	Diagnosis code		7840^296.23^7820^PS_BRA
4	Diagnosis description	Diagnosis from the last visit	HEADACHE VASCULAR
5	Diagnosis date/time
6	Diagnosis/DRG type
7	Major diagnostic category
8	Diagnosis related group (DRG)
9	DRG approval indicator
10	DRG grouper review code
11	Outlier type
12	Outlier days
13	Outlier cost
14	Grouper version and type
15	Diagnosis Priority
16	Diagnosing Clinician
17	Diagnosis Classification
18	Confidential Indicator
19	Attestation Date/Time

(v20/01) 6

GT1

Seq	Field	Comment	Example
1	Set ID
2	Guarantor Number	Same as Account Number	92
3	Guarantor Name	<family name (ST)> ^ <given name (ST)> ^ <middle initial or	Jones^Tom^H
4	Guarantor Spouse Name	Not used. name (ST)>
5	Guarantor Address	<street address (ST)> ^^ <city (ST)> ^ <state or province (ST)> ^ <zip or postal code(ST)>	123 Easy St.^Pasadena^CA^91107
6	Guarantor Ph Num-	(xxx) xxx-xxxx	(626) 555-1212
7	Guarantor Ph Num- Home Business	Not used.
8	Guarantor Date	yyyymmdd	20080118
9	Guarantor Sex Birth	Male, Female	F
10	Guarantor Type	Not used.
11	Guarantor Relationship	Not used.
12	Guarantor SSN	xxx-xx-xxxx
13	Guarantor Date - Begin	Not used.
14	Guarantor Date - End	Not used.
15	Guarantor Priority	Not used.
16	Guarantor Employer	Not used.
17	Guarantor Employer Name	Not used.
18	Guarantor Employer Address	Not used.
19	Guarantor Employee ID	Not used.
20	Phone Number Number Guarantor Employment	Not used.
21	Guarantor Organization Status	Not used.
22	Guarantor Billing Hold Name	Not used.
23	Guarantor Credit Rating Flag	Not used.
24	Guarantor Death Date Code	Not used.
25	Guarantor Death Flag And Time	Not used.
26	Guarantor Charge	Not used.
27	Guarantor Household Adjustment Code	Not used.
28	Guarantor Household Annual Income	Not used.
29	Guarantor Employer ID Size	Not used.
30	Guarantor Marital Status Number	Not used.
31	Guarantor Hire Effective Code	Not used.
32	Employment Stop Date Date	Not used.
33	Living Dependency	Not used.
34	Ambulatory Status	Not used.
35	Citizenship	Not used.
36	Primary Language	Primary language spoken	Spanish
37	Living Arrangement	Not used.
38	Publicity Code	Not used.
39	Protection Indicator	Not used.
40	Student Indicator	Not used.
41	Religion	Not used.
42	Mother's Maiden Name	Not used.
43	Nationality	Not used.

(v20/01) 7

44	Ethnic Group	Ethnicity Code	2170-9
45	Contact Person's Name	Contact selected by patient
46	Contact Person's Telephone Number	(xxx) xxx-xxxx	(213) 555-1212
47	Contact Reason	Not used.
48	Contact Relationship	Not used.
49	Job Title	Not used.
50	Job Code/Class	Not used.
51	Guarantor Employer's	Not used.
52	Handicap Organization Name	Not used.
53	Job Status	Not used.
54	Guarantor Financial	Not used.
55	Guarantor Race Class	Race Code	1760-8

EVN

	Seq		Field		Comment		Example
	1		Event Type Code		Message Type		A04
	2		Date/Time of Event And Time		yyymmddhhmm		200706150000
	3		Date/Time Planned Event		Not used.
	4		Event Reason Code		Not used.
	5		Adjustment Code Operator ID		Not used.
	6		Event Occurred Annual Income		Not used.
	7		Event Facility Size		Not used.
STF			Number Number
Seq		Field		Comment		Example
1		Set ID
2		Staff ID Code		Ref. Phy. Prctc. Code
3		Staff Name		Ref. Phy. Name		Last^First^Middle
4		Staff Type
5		Sex
6		Date Of Birth
7		Active/Inactive
8		Department
9		Service
10		Phone		Phone^Fax		(222)222-2222^(222)-222-2233
11		Office/Home Address		Office Address		Street^City^State^Zip
12		Inactivation Date
13		Inactivation Date
14		Backup Person ID
15		E-Mail Address
16		Preferred Phone

PRA

Seq

Field

Comment

Example

(v20/01) 8

1	Set ID
2	Practitioner Group	Physican Code
3	Practitioner Category
4	Provider Billing	Physician NPI #
5	Specialty
6	Practitioner Id Num	UPIN
7	Privileges

Financial Billing Message (DFT)

These are the specifications for the Financial Billing Messages that we expect.

Sequence for each segment start from zero.

Seq in brackets [ ] means this is the default seq and by using IMPORT_HL7 table user
can set the system to read this data from a different seq in that segment.

Having these in mind, the following are segments that we import:

Segment Seq Data

-------------------------------------------------------------------------------------
MSH 5 ClinicName

MSH 8 MessageType

Segment Seq Data

-------------------------------------------------------------------------------------
PID [2] Account

PID 5 Patient's Name (LastName^FirstName)

PID 7 Date Of Birth (YYYYMMDD)
PID 8 Gender

  PID 11 Address (add1^add2^city^state^zip)
  PID 13 Phone ( (999)999-9999) We do not accept name in this field
  PID 16 Marital Status

PID 19 Social Security Number

When we receive the information and the Vendor sends the account# that is in Intellect, we will compare the LastName DOB and SSN.

Versions prior to 6/22/2018: When we receive the information and if the account does not exist or the account# is null or zero, we do a search on the PA_NAME DOB & SSN and if no match is found, the program adds the Patient into the system.

Version date 6/22/2018 & greater: When we receive the information and if the account does not exist or the account# is null or zero, we NOW search for DOB, PA_LAST_NAME, PA_FIRST_NAME AND SSN. If the information in the HL7 includes a 'Suffix' and we ADD the patient, then we also add the suffix.

(v20/01) 9

Version Date 11/17/2020; A new field was added to the Patient Table, pa_hl7_id (in the
PID-4 for incoming HL7 messages), to hold/house outside Vendor EMR Patient ID/Number for
ADT/DFT import.

This field is used to accommodate Vendors who are sending ADT or DFT information where they are not or unable to include the OSI PA_ACCOUNT in the PID-2

This option is ONLY available as a FFS (fee for service) and is billable to the PCS Client.

Before moving forward, Prime Clinical Systems must first receive a sample file from the Vendor for review. Once it is determined that the sample file is within PCS guidelines, a PT Demo file from the EMR must be Provided which includes the PA_NAME, PA_DOB, PA_ADDRESS, EMR PATIENT ID/NUMBER. The EMR PATIENT ID/NUMBER would only be added to existing OSI Patient Records.

Segment Seq Data

-------------------------------------------------------------------------------------
PD1 4 Patient Primary Care Provider ID Number

NK1 NK1	2 Emergency Contact Name 5 Emergency Contact Phone#
PV1		The Billing Provider when the Provider in FT1 [20] is a cost center. Referring Doctor (Code^LastName^FirstName) Note: The Codes of the EMR need to be mapped to the Referring Doctor codes of Intellect PM system. Hospital Date of Admission (DOA) Hospital Date of Discharge (DOD) Note: Intellect will accept the DOA in PV1-44 and the DOD in PV1-45, insert the information into a Generic Encounter, and attach the Encounter number to the charge data being imported. <Encounter Description> : IMPORTED DATA. <Hospitalization From> : This field is populated with the Date of Admission listed in PV1-44. <Hospitalization To>: This field is populated with the Date of Discharge listed in PV1-45. Note: To facilitate this option, the <Attach Encounter> field on the Utilityà Set Upà Parameter must not be set to 'N' or 'X'.
PV1
PV1 PV1

  GT1 3 Guarantor Name
  GT1 5 Guarantor Address
  GT1 6 Guarantor Phone
  GT1 7 Guarantor Phone-Work
  GT1 8 Guarantor DOB

GT1 9 Guarantor Gender
GT1 12 Guarantor SSN

  GT1 17 Guarantor Employer Address
  GT1 30 Guarantor Marital Status
  GT1 51 Guarantor Employer Name

(v20/01) 10

Segment Seq Data

-------------------------------------------------------------------------------------
  IN1 [3] Insurance Company ID
  IN1 4 Insurance Company Name
  IN1 5 Insurance Company Address
  IN1 8 Group Number

IN1 12 Coverage From

IN1 13 Coverage To

IN1 16 Insured Name

IN1 17 Insured's Relationship To Patient
IN1 18 Insured's DOB

IN1 19 Insured's Address

IN1 36 Policy Number

IN1 43 Insured's Gender

FT1 3 Transaction ID (same as SCH.5)

FT1 4 Date Of Service (yyyymmdd)
FT1 6 Transaction type. Values: CG for Charge, PY for Payment, AJ

for Adjustment

FT1 [7] Transaction Code / Panel Code, Source of Payment or Adjustment
FT1 9 Transaction Alternate description (Remark) \

Note: The Codes of the EMR need to be mapped to the Procedure codes of Intellect PM system.

FT1 10 Quantity

FT1 11 Transaction Amount

FT1 15 Approved amount

FT1 [16] Facility Info(PlaceOfService^^^FacilityCode^^FacilityName)

Note: The Codes of the EMR need to be mapped to the Facility codes of Intellect PM system.

FT1 17 To put a charge on hold set this field to Y if not leave it blank.
FT1 [19] Diagnosis

Note: The Codes of the EMR need to be mapped to the Diagnosis codes of Intellect PM system.

FT1 [20] Provider Code

Note: The Codes of the EMR need to be mapped to the Provider codes of Intellect PM system.

FT1 22 Cost

FT1 26 Modifier

(Invalid modifiers will be rejected)

NOTE:

For any reason if the charges do not get posted there will be an email sent to the email
address that is entered in the Utility -> Setup -> Clinic -> Notification E-mail field.

The following must be configuered in the Utility -> Tools -> Configuratin ->
screen for the E-mail to work:

(v20/01) 11

SMTP SERVER

SMTP PORT

SMTP SSL

SMTP AUTENTICATION

USER NAME

PASSWORD

ADT messages support the following options:

A04 is created when a new patient record is created.
A08 is created when the patient demographic is modified.

SIU messages support the following options:

S12 is created when a new appointment is entered.
S14 is created when an appointment is modified.
S15 is created when an appointment is canceled or deleted.
S26 is created when a patient's appointment is tagged as a no show.
S15 and S12 are generated in the event of an appointment reschedule.

(v20/01) 12