Event Type	Event Description	Segment Composition	Product	Product Option Trigger Event(s)	Notes
					
A01	Inpatient Admission	MSH	AVPM	Admission	
		EVN			
		PID			
		PV1			
		[{OBX}]			
		[{AL1}]			
		[{DG1}]			
		[{IN1}]			
					
					
A02	Transfer (Program/Bed)	MSH	AVPM	Bed Assignment	
		EVN	AVPM	Program Transfer	
		PID			
		PV1			
		[{OBX}]			
					
					
A03	Discharge	MSH	AVPM	Pre-admission Discharge	
		EVN		Discharge	
		PID			
		PV1			
		[{DG1}]			
		[{OBX}]			
					
					
A04	Outpatient/Partial Admission	MSH	AVPM	Admission	
		EVN	AVPM	Outpatient Admission	
		PID			
		PV1			
		[{OBX}]			
		[{AL1}]			
		[{DG1}]			
		[{IN1}]			
					
					
A05	Pre-admit	MSH	AVPM	Pre-admission	
		EVN			
		PID			
		PV1			
		[{OBX}]			
		[{AL1}]			
		[{DG1}]			
		[{IN1}]			
					
					
A08	Update	MSH	AVPM	Update Client Data	
		EVN	AVPM	Admission (Edit) 	
		PID	AVPM	Outpatient Admission (Edit)	
		PV1	AVPM	Diagnosis Input	
		[{OBX}]	AVPM	Attending Clinician Assignment	
		[{AL1}]	AVPM	Delete Last Movement	
		[{DG1}]	AVPM	Change Program/Admission Date	
		[{IN1}]	Order Entry	Client Allergies And Hypersensitivities	
			Order Entry	Client Height And Weight	
					
					
A11	Cancel Admission	MSH	AVPM	Delete Last Movement	
		EVN			
		PID			
		PV1			
		[{OBX}]			
		[{DG1}]			
					
					
A13	Cancel Discharge	MSH	AVPM	Delete Last Movement	
		EVN			
		PID			
		PV1			
		[{OBX}]			
		[{AL1}]			
		[{DG1]}			
		[{IN1}]			
					
					
A17	Bed Swap	MSH	AVPM	Bed Switch	
		EVN			
		PID			
		PV1			
		PID			
		PV1			
					
					
A21	Leave	MSH	AVPM	Leave	
		EVN			
		PID			
		PV1			
		[{OBX}]			
					
					
A22	Return From Leave	MSH	AVPM	Return From Leave	
		EVN			
		PID			
		PV1			
		[{OBX}]			
					
					
A34	Merge Patient Info - Patient ID Only	MSH	AVPM	Client Merge - Non-episodic	
		EVN			
		PID			
		MRG			
					
					
A35	Merge Patient Info - Account Number Only	MSH	AVPM	Client Merge - Episode	
		EVN			
		PID			
		MRG			
					

A47	Change Patient Id - Internal	MSH	AVPM	Change MR Number	
		EVN		Change MPI MR#	
		PID
		MRG





Field#	Field Description	ReqYN	Length	Product Field Description	Product Field Mapping	Notes

1	Field Separator	Y	1			 '|'
2	Encoding Characters	Y	4			 '^~\&'
3	Sending Application	N	180			 'CSM'
4	Sending Facility	N	180	Facility Number (as defined in option 'Facility Defaults')	"^BILL(%CC,14)"	
5	Receiving Application	N	180	N/A		
6	Receiving Facility	N	180	N/A		
7	Date/Time Of Message	N	26			Date/Time Stamp
8	Security	N	40	N/A		
9.1	Message Type	Y	7			Message Type
9.2	Message Type	Y				Trigger Event (see Events Supported)
10	Message Control Id	Y	20			Unique Message Id
11	Processing Id	Y	3			 'P' = production 'T' = test
12	Version Id	Y	60			 '2.3.1'
13	Sequence Number	N	15	N/A		
14	Continuation Pointer	N	180	N/A
15	Accept Acknowledgement Type	N	2	N/A
16	Application Acknowledgement Type	N	2	N/A
17	Country Code	N	2	N/A
18	Character Set	N	10	N/A
19	Principle Language Of Message	N	60	N/A





Field#	Field Description	ReqYN	Length	Product Field Description	Product Field Mapping	Notes

1	Event Type Code	Y	3			Event Type
2	Recorded Date/Time	Y	26			Date/Time Stamp
3	Date/Time Planed Event	N	26	N/A		
4	Event Reason Code	N	3	N/A		
5	Operator Id	N	60	N/A		
6	Event Occurred	N	26			Date Of Transfer/Leave/Return/etc
						Populated for the following events:
						 A02
						 A17
						 A21
						 A22
						 A47


Field#	Field Description	ReqYN	Length	Product Field Description	Product Field Mapping	Notes

1	Event Type Code	Y	3			Event Type
2	Recorded Date/Time	Y	26			Date/Time Stamp
3	Date/Time Planed Event	N	26	N/A		
4	Event Reason Code	N	3	N/A		
5	Operator Id	N	60	N/A		
6	Event Occurred	N	26			Date Of Transfer/Leave/Return/etc
						Populated for the following events:
						 A02
						 A17
						 A21
						 A22
						 A47


Field#	Field Description	ReqYN	Length	Product Field Description	Product Field Mapping	Notes

1	Set ID	N	4	Iteration Count		
2	Patient ID (External)	N	20	N/A		
3	Patient ID (Internal)	Y	20	Assigned ID	1	static
4	Alternate Patient ID	N	20	N/A		
5.1	Patient Name	Y	48	Client Name - Last	2	static
5.2		Y		Client Name - First	3	
5.3		N		Client Name - Middle Initial	2	
6	Mother's Maiden Name	N	48	N/A		
7	Date/Time Of Birth	N	26	Date Of Birth	22	static
8	Sex	N	1	Sex	3	static (code)
9	Patient Alias	N	48	N/A		
10.1	Race	N	80	Race Code	116	static (code)
10.2		N		Race Description		code value
11.1	Patient Address	N	106	Client's Address - Street	90	static
11.2		N		Client's Address - Street 2	98	static
11.3		N		Client's Address - City	91	static
11.4		N		Client's Address - State	92	static (code)
11.5		N		Client's Address - Zipcode	94	static
11.9		N		Client's Address - County	93	static (code)
12	County Code	N	4	N/A		
13	Phone Number - Home	N	40	Client's Home Phone	95	static
14	Phone Number - Business	N	40	Client's Work Phone	96	static
15.1	Primary Language	N	60	Primary Language	149	static (code)
15.2		N		Primary Language Description		code value
16.1	Marital Status	N	80	Marital Status	10	static (code)
16.2		N		Marital Status Description		code value
17.1	Religion	N	80	Religion Code	9	static (code)
17.2				Religion Description		code value
18	Patient Account Number	N	20	Assigned ID and Episode and Facility Number (as defined in option 'Facility Defaults')		Example value: 000000001-1-42
19	SSN Number - Patient	N	16	Social Security Number	6	static
20	Driver's License Number	N	25	N/A		
21	Mother's Identifier	N	20	N/A		
22.1	Ethnic Group	N	80	Ethnic Origin	8	static (code)
22.2				Ethnic Origin Description		code value
23	Birth Place	N	60	N/A		
24	Multiple Birth Indicator	N	1	N/A		
25	Birth Order	N	2	N/A		
26	Citizenship	N	80	N/A		
27	Veterans Military Status	N	60	N/A		
28	Nationality	N	80	N/A		
29	Patient Death And Time	N	26	N/A		
30	Patient Death Indicator	N	1	N/A		


Field#	Field Description	ReqYN	Length	Product Field Description	Product Field Mapping	Notes

1	SetId	N	4	Iteration Count		
2	Patient Class	Y	1	(I)npatient or (O)utpatient	50	partial treatment setting classified as outpatient
3.1	Assigned Patient Location - Unit	N	80	Unit	202	last location on file for episode
3.2	Assigned Patient Location - Room	N		Room	203	last location on file for episode
3.3	Assigned Patient Location - Bed	N		Bed	204	last location on file for episode
3.4	Assigned Patient Location - Facility			Facility Number (as defined in option 'Facility Defaults')		Contains same value as in segment 'MSH' field 4.
4	Admission Type	N	2	N/A		
5	Preadmit Number	N	20	N/A		
6.1	Prior Patient Location	N	80	Unit	202	location prior to last for episode
6.2	Prior Patient Location	N		Room	203	location prior to last for episode
6.3	Prior Patient Location	N		Bed	204	location prior to last for episode
6.4	Prior Patient Location - Facility			Facility Number (as defined in option 'Facility Defaults')		Contains same value as in segment 'MSH' field 4.
7.1	Attending Doctor	N	60	Attending Pracitioner Id and Facility Number (as defined in option 'Facility Defaults')	36	last attending on file for episode. Example value: 000004-42
7.2				Attending Pracitioner Last Name	2	
7.3				Attending Pracitioner First Name	2	
7.4				Attending Pracitioner Middle Initial	2	
8	Referring Doctor	N	60	N/A		
9	Consulting Doctor	N	60	N/A		
10	Hospital Service	N	3	N/A		
11	Temporary Location	N	80	N/A		
12	Preadmit Test Indicator	N	2	N/A		
13	Readmission Indicator	N	2	N/A		
14	Admit Source	N	3	N/A		
15	Ambulatory Status	N	2	N/A		
16	VIP Indicator	N	2	N/A		
17.1	Admitting Doctor	N	60	Admitting Practitioner Id and Facility Number (as defined in option 'Facility Defaults')	1154	Example value: 000004-42
17.2				Admitting Practitioner Last Name	2	
17.3				Admitting Practitioner First Name	2	
17.4				Admitting Practitioner Middle Initial	2	
18	Patient Type	N	2	N/A		
19	Visit Number	N	20	N/A
20	Financial Class	N	50	N/A
21	Charge Price Indicator	N	2	N/A
22	Courtesy Code	N	2	N/A
23	Credit Rating	N	2	N/A
24	Contract Code	N	2	N/A
25	Contract Effective Date	N	8	N/A
26	Contract Amount	N	12	N/A
27	Contract Period	N	3	N/A
28	Interest Code	N	2	N/A
29	Transfer To Bad Debt Code	N	1	N/A
30	Transfer To Bad Debt Date	N	8	N/A
31	Bad Debt Agency Code	N	10	N/A
32	Bad Debt Transfer Amount	N	12	N/A
33	Bad Debt Recovery Amount	N	12	N/A
34	Delete Account Indicator	N	1	N/A
35	Delete Account Date	N	8	N/A		
36	Dischage Disposition	N	3	N/A		
37	Discharge To Location	N	25	N/A		
38	Diet Type	N	2	N/A		
39	Servicing Facility	N	2	N/A		
40	Bed Status	N	1	N/A		
41	Account Status	N	2	N/A		
42	Pending Location	N	80	N/A		
43	Prior Temporary Location	N	80	N/A		
44	Admit DateTime	N	26	Admission Date/Time	42+45	episode admission date/time
45	Discharge DateTime	N	26	Discharge Date/Time	55+213	episode discharge date/time
46	Current Patient Balance	N	12	N/A		
47	Total Charge	N	12	N/A		
48	Total Adjustments	N	12	N/A		
49	Total Payments	N	12	N/A		
50	Alternate VisitId	N	20	N/A		
51	Visit Indicator	N	1	N/A
52	Other Health Provider	N	6	N/A




Field#	Field Description	ReqYN	Length	Product Field Description	Product Field Mapping	Notes

1	SetId	N	4	Iteration Count		
2	Patient Class	Y	1	(I)npatient or (O)utpatient	50	partial treatment setting classified as outpatient
3.1	Assigned Patient Location - Unit	N	80	Unit	202	last location on file for episode
3.2	Assigned Patient Location - Room	N		Room	203	last location on file for episode
3.3	Assigned Patient Location - Bed	N		Bed	204	last location on file for episode
3.4	Assigned Patient Location - Facility			Facility Number (as defined in option 'Facility Defaults')		Contains same value as in segment 'MSH' field 4.
4	Admission Type	N	2	N/A		
5	Preadmit Number	N	20	N/A		
6.1	Prior Patient Location	N	80	Unit	202	location prior to last for episode
6.2	Prior Patient Location	N		Room	203	location prior to last for episode
6.3	Prior Patient Location	N		Bed	204	location prior to last for episode
6.4	Prior Patient Location - Facility			Facility Number (as defined in option 'Facility Defaults')		Contains same value as in segment 'MSH' field 4.
7.1	Attending Doctor	N	60	Attending Pracitioner Id and Facility Number (as defined in option 'Facility Defaults')	36	last attending on file for episode. Example value: 000004-42
7.2				Attending Pracitioner Last Name	2	
7.3				Attending Pracitioner First Name	2	
7.4				Attending Pracitioner Middle Initial	2	
8	Referring Doctor	N	60	N/A		
9	Consulting Doctor	N	60	N/A		
10	Hospital Service	N	3	N/A		
11	Temporary Location	N	80	N/A		
12	Preadmit Test Indicator	N	2	N/A		
13	Readmission Indicator	N	2	N/A		
14	Admit Source	N	3	N/A		
15	Ambulatory Status	N	2	N/A		
16	VIP Indicator	N	2	N/A		
17.1	Admitting Doctor	N	60	Admitting Practitioner Id and Facility Number (as defined in option 'Facility Defaults')	1154	Example value: 000004-42
17.2				Admitting Practitioner Last Name	2	
17.3				Admitting Practitioner First Name	2	
17.4				Admitting Practitioner Middle Initial	2	
18	Patient Type	N	2	N/A		
19	Visit Number	N	20	N/A
20	Financial Class	N	50	N/A
21	Charge Price Indicator	N	2	N/A
22	Courtesy Code	N	2	N/A
23	Credit Rating	N	2	N/A
24	Contract Code	N	2	N/A
25	Contract Effective Date	N	8	N/A
26	Contract Amount	N	12	N/A
27	Contract Period	N	3	N/A
28	Interest Code	N	2	N/A
29	Transfer To Bad Debt Code	N	1	N/A
30	Transfer To Bad Debt Date	N	8	N/A
31	Bad Debt Agency Code	N	10	N/A
32	Bad Debt Transfer Amount	N	12	N/A
33	Bad Debt Recovery Amount	N	12	N/A
34	Delete Account Indicator	N	1	N/A
35	Delete Account Date	N	8	N/A		
36	Dischage Disposition	N	3	N/A		
37	Discharge To Location	N	25	N/A		
38	Diet Type	N	2	N/A		
39	Servicing Facility	N	2	N/A		
40	Bed Status	N	1	N/A		
41	Account Status	N	2	N/A		
42	Pending Location	N	80	N/A		
43	Prior Temporary Location	N	80	N/A		
44	Admit DateTime	N	26	Admission Date/Time	42+45	episode admission date/time
45	Discharge DateTime	N	26	Discharge Date/Time	55+213	episode discharge date/time
46	Current Patient Balance	N	12	N/A		
47	Total Charge	N	12	N/A		
48	Total Adjustments	N	12	N/A		
49	Total Payments	N	12	N/A		
50	Alternate VisitId	N	20	N/A		
51	Visit Indicator	N	1	N/A
52	Other Health Provider	N	6	N/A



Field#	Field Description	ReqYN	Length	Product Field Description	Product Field Mapping	Notes

1	SetId	N	4	Iteration Count		
2	Patient Class	Y	1	(I)npatient or (O)utpatient	50	partial treatment setting classified as outpatient
3.1	Assigned Patient Location - Unit	N	80	Unit	202	last location on file for episode
3.2	Assigned Patient Location - Room	N		Room	203	last location on file for episode
3.3	Assigned Patient Location - Bed	N		Bed	204	last location on file for episode
3.4	Assigned Patient Location - Facility			Facility Number (as defined in option 'Facility Defaults')		Contains same value as in segment 'MSH' field 4.
4	Admission Type	N	2	N/A		
5	Preadmit Number	N	20	N/A		
6.1	Prior Patient Location	N	80	Unit	202	location prior to last for episode
6.2	Prior Patient Location	N		Room	203	location prior to last for episode
6.3	Prior Patient Location	N		Bed	204	location prior to last for episode
6.4	Prior Patient Location - Facility			Facility Number (as defined in option 'Facility Defaults')		Contains same value as in segment 'MSH' field 4.
7.1	Attending Doctor	N	60	Attending Pracitioner Id and Facility Number (as defined in option 'Facility Defaults')	36	last attending on file for episode. Example value: 000004-42
7.2				Attending Pracitioner Last Name	2	
7.3				Attending Pracitioner First Name	2	
7.4				Attending Pracitioner Middle Initial	2	
8	Referring Doctor	N	60	N/A		
9	Consulting Doctor	N	60	N/A		
10	Hospital Service	N	3	N/A		
11	Temporary Location	N	80	N/A		
12	Preadmit Test Indicator	N	2	N/A		
13	Readmission Indicator	N	2	N/A		
14	Admit Source	N	3	N/A		
15	Ambulatory Status	N	2	N/A		
16	VIP Indicator	N	2	N/A		
17.1	Admitting Doctor	N	60	Admitting Practitioner Id and Facility Number (as defined in option 'Facility Defaults')	1154	Example value: 000004-42
17.2				Admitting Practitioner Last Name	2	
17.3				Admitting Practitioner First Name	2	
17.4				Admitting Practitioner Middle Initial	2	
18	Patient Type	N	2	N/A		
19	Visit Number	N	20	N/A
20	Financial Class	N	50	N/A
21	Charge Price Indicator	N	2	N/A
22	Courtesy Code	N	2	N/A
23	Credit Rating	N	2	N/A
24	Contract Code	N	2	N/A
25	Contract Effective Date	N	8	N/A
26	Contract Amount	N	12	N/A
27	Contract Period	N	3	N/A
28	Interest Code	N	2	N/A
29	Transfer To Bad Debt Code	N	1	N/A
30	Transfer To Bad Debt Date	N	8	N/A
31	Bad Debt Agency Code	N	10	N/A
32	Bad Debt Transfer Amount	N	12	N/A
33	Bad Debt Recovery Amount	N	12	N/A
34	Delete Account Indicator	N	1	N/A
35	Delete Account Date	N	8	N/A		
36	Dischage Disposition	N	3	N/A		
37	Discharge To Location	N	25	N/A		
38	Diet Type	N	2	N/A		
39	Servicing Facility	N	2	N/A		
40	Bed Status	N	1	N/A		
41	Account Status	N	2	N/A		
42	Pending Location	N	80	N/A		
43	Prior Temporary Location	N	80	N/A		
44	Admit DateTime	N	26	Admission Date/Time	42+45	episode admission date/time
45	Discharge DateTime	N	26	Discharge Date/Time	55+213	episode discharge date/time
46	Current Patient Balance	N	12	N/A		
47	Total Charge	N	12	N/A		
48	Total Adjustments	N	12	N/A		
49	Total Payments	N	12	N/A		
50	Alternate VisitId	N	20	N/A		
51	Visit Indicator	N	1	N/A
52	Other Health Provider	N	6	N/A





Field#	Field Description	ReqYN	Length	Option	Product Field Description	Product Field Mapping	Notes
							
1	Set ID		4				
							
2	Value Type		3				Populate with  'NM'
							
3.1	Observation Identifier - Code	Y	590				We will be utilizing LOINC identifiers. For height the value sent will be '3137-7' and for weight '3141-9'
3.2	Observation Identfier - Text						"Populate with ""HEIGHT' or 'WEIGHT' based on value"
3.3	Observation Identifier - Name Of Coding System						 'LOINC'
							
4	Observation Sub-ID		20	N/A	N/A		
							
5	Observation Value			Order Entry (Client Height And Weight)	Height or Weight	10100 or 10103	
							
6	Units		60	Order Entry (Client Height And Weight)	Extended dictionary off of 'Height Unit' (10101) or 'Weight Unit' (10104)		An extended dictionary has been added off of 'Height Unit' and 'Weight Unit' to allow for the input of units of measure codes/abbreviations
							
7	References Range		60	N/A	N/A		
							
8	Abnormal Flags		5	N/A	N/A		
							
9	Probability		5	N/A	N/A		
							
10	Nature Of Abnormal Test		2	N/A	N/A		
							
11	Observ Results Status	Y	1				 'C'
							
12	Date Last Obs Normal Values		26	N/A	N/A		
							
13	User Defined Access Checks		20	N/A	N/A		
							
14	Date/Time Of The Observation		26	Order Entry (Client Height And Weight)	Date Height Recorded or Date Weight Recorded	10102 or 10105	
							
15	Producers ID		60	N/A	N/A		
							
16	Responsible Observer		80	N/A	N/A		
							
17	Observation Method		60	N/A	N/A		


Field#	Field Description	ReqYN	Length	Option	Product Field Description	Product Field Mapping	Notes
							
1	Set ID	Y	4				
							
2	Allergy Type		2		N/A		
							
3.1	Allergy Code	Y	60	Order Entry (Client Allergies And Hypersensetivities)	Allergen/Reactant	10000	The default value will be the 'Allergen/Reactant' code. This will be overriden with any value defined in the extended dictionary 'Interface Code' (field 10008) which is off of field 'Allergen/Reactant'
3.2	Allergy Description						The default value will be the 'Allergen/Reactant' code description. This will be overriden with any value defined in the extended dictionary 'Interface Description' (field 10010) which is off of field 'Allergen/Reactant'
							
4	Allergy Severity		2	Order Entry (Client Allergies And Hypersensetivities)	Reaction Severity	10003	
							
5	Allergy Reaction		15	Order Entry (Client Allergies And Hypersensetivities)	Reactions	10002	
							
6	Identification Date		8	Order Entry (Client Allergies And Hypersensetivities)	Date Recognized	10004	
							
							
*** Only those allergy records that have a value of 'Y' for the extended dictionary field 'Include In Clinical Screening' (field 10007) which is off of 'Status' (10001) will be sent across the interface							



Field#	Field Description	ReqYN	Length	Option	Product Field Description	Product Field Mapping	Notes

1	Set ID	Y	4		Iteration Counter		
2	Diagnosis Coding Method	N	2		N/A		
3.1	Diagnosis Code	Y	60	AVPM (Diagnosis)	Diagnosis Code	Any axis I or II diagnosis code that maps to a valid ICD9 diagnosis code. Any axis III diagnosis code	Will pull information from last diagnosis record on file for episode in question
3.2		Y		AVPM (Diagnosis)	Diagnosis Description		
3.3		Y		AVPM (Diagnosis)	Diagnosis Coding System		 'I9'
4	Diagnosis Description	N	40		N/A		
5	Diagnosis Date/Time	N	26	AVPM (Diagnosis)	Diagnosis Date	124	last diagnosis(P) record on file for episode
6	Diagnosis Type	Y	2	AVPM (Diagnosis)	"(A)dmitting, (W)orking or (F)inal"	125	last diagnosis(P) record on file for episode. Admission='A' Discharge='F' else 'W'
7	Major Diagnositic Category	N	60		N/A		
8	Diagnostic Related Group	N	4		N/A		
9	DRG Approval Indicator	N	2		N/A		
10	DRG Grouper Review Code	N	2		N/A		
11	Outlier Type	N	60		N/A		
12	Outlier Days	N	3		N/A		
13	Outlier Costs	N	12		N/A		
14	Grouper Version And Type	N	4		N/A		
15	Diagnosis Priority	N	2		N/A		
16.1	Diagnosing Clinician	N	60	AVPM (Diagnosis)	Diagnosing Practitioner Id and Facility Number (as defined in option 'Facility Defaults')	1165	Example value: 000004-42
16.2		N	60	AVPM (Diagnosis)	Diagnosing Practitioner Last Name	2	
16.3		N	60	AVPM (Diagnosis)	Diagnosing Practitioner First Name	2	
16.4		N	60	AVPM (Diagnosis)	Diagnosing Practitioner Middle Name	2	
17	Diagnosis Classification	N	3		N/A		
18	Confidential Indicator	N	1		N/A		
19	Attestation Date/Time	N	26		N/A	



Field#	Field Description	ReqYN	Length	Option	Product Field Description	Product Field Mapping	Notes
							
1	Set ID						
2.1	Insurance Plan ID			AVPM (Financial Eligibility)	Guarantor Plan	714	
2.2							Plan Desc
3.1	Insurance Company ID			AVPM (Financial Eligibility)	Guarantor #	680	
4.1	Insurance Company Name			AVPM (Financial Eligibility)	Guarantor Name	239	
5.1	Insurance Company Address			AVPM (Financial Eligibility)	Guarantor Address - Line 1	240	
5.2	Street 2			AVPM (Financial Eligibility)	Guarantor Address - Line 2	241	
5.3	City			AVPM (Financial Eligibility)	Guarantor Address - City	242	
5.4	State			AVPM (Financial Eligibility)	Guarantor Address - State	243	
5.5	Zip			AVPM (Financial Eligibility)	Guarantor Address - Zip	244	
6	Insurance Company Contact Person				N/A		
7.1	Insurance Company Phone			AVPM (Financial Eligibility)	Guarantor Phone Number	245	
8	Group Number			AVPM (Financial Eligibility)	Subscriber Group Number	265	
9.1	Group Name			AVPM (Financial Eligibility)	Subscriber Group Name	264	
10.1	Insured's Group Emp Id			AVPM (Financial Eligibility)	Subscriber Employer ID Number	10202	
11.1	Insured's Group Emp Name			AVPM (Financial Eligibility)	Subscriber Employer Name	258	
12	Plan Effective Date			AVPM (Financial Eligibility)	Coverage Effective Date	712	
13	Plan Expiration Date			AVPM (Financial Eligibility)	Coverage Expiration Date	713	
14	Authorization Information				N/A		
15	Plan Type				N/A		
16.1	Name Of Insured - Last			AVPM (Financial Eligibility)	Subscriber Name	246	
16.2	Name Of Insured - First						
16.3	Name Of Insured - Middle						
17.1	Insured's Relationship To Patient			AVPM (Financial Eligibility)	Client's Relationship To Subscriber	247	* Note that relationship as defined in PM is the reverse of what this field indicates
17.2							Relationship Desc
18	Insured's Date Of Birth			AVPM (Financial Eligibility)	Subscriber Date Of Birth	326	
19.1	Insured's Address			AVPM (Financial Eligibility)	Subscriber Address - Street Line 1	248	
19.2	Street 2			AVPM (Financial Eligibility)	Subscriber Address - Street Line 2	249	
19.3	City			AVPM (Financial Eligibility)	Subscriber Address - City	250	
19.4	State			AVPM (Financial Eligibility)	Subscriber Address - State	251	
19.5	Zip			AVPM (Financial Eligibility)	Subscriber Address - Zip	252	
20	Assignment Of Benefits			AVPM (Financial Eligibility)	Assignment Of Benefits	277	Y/N
21	Coordination Of Benefits			AVPM (Financial Eligibility)	Coordination Of Benefits	1058	Y/N
22	Coord Of Ben Priority				N/A		
23	Notice Of Admission Flag				N/A		
24	Notice Of Admission Date				N/A		
25	Report Of Eligibility Flag				N/A		
26	Report Of Eligibility Date				N/A		
27	Release Information Code			AVPM (Financial Eligibility)	Subscriber Release Of Info	278	Y/N
28	Pre-Admit Cert				N/A		
29	Verification Date/Time				N/A		
30	Verification By				N/A		
31	Type Of Agreement Code				N/A		
32	Billing Status				N/A		
33	Lifetime Reserve Days				N/A		
34	Delay Before LR Day				N/A		
35	Company Plan Code				N/A		
36	Policy Number			AVPM (Financial Eligibility)	Subscriber Policy Number	263	
37	Policy Deductibles				N/A		
38	Policy Limit Amount				N/A		
39	Policy Limit Days				N/A		
40	Room Rate - Semi				N/A		
41	Room Rate - Private				N/A		
42.1	Insured's Employment Status			AVPM (Financial Eligibility)	Subscriber Employment Status	256	
42.2							Status Desc
43	Insured's Sex			AVPM (Financial Eligibility)	Subscriber Sex	255	
44.1	Insured's Employer's Address			AVPM (Financial Eligibility)	Subscriber Employer Address - Street 1	259	
44.2	Street 2				N/A		
44.3	City			AVPM (Financial Eligibility)	Subscriber Employer Address - City	261	
44.4	State			AVPM (Financial Eligibility)	Subscriber Employer Address - State	262	
44.5	Zip			AVPM (Financial Eligibility)	Subscriber Employer Address - Zip	260	
45	Verification Status				N/A		
46	Prior Insurance Plan ID				N/A
47	Coverage Type				N/A
48	Handicap				N/A
49	Insured's ID Number				N/A



Field#	Field Description	ReqYN	Length	Option	Product Field Description	Product Field Mapping	Notes

 	Prior Patient Id - Internal	Y	20	AVPM (Change MR#) (Client Merge)	Assigned ID or Source ID (depending on option being accessed)		
2	Prior Alternate Patient Id	N	16		N/A		
3	Prior Patient Account Number	N	20	AVPM (Client Merge)	Assigned ID or Source ID and Episode or Source Episode and Facility Number (as defined in option 'Facility Defaults')		Same format as used in segment 'PID' field 18
4	Prior Patient Id - External	N	16		N/A		
5	Prior Visit Number	N	15		N/A		
6	Prior Alternate Visit Id	N	20		N/A		
7	Prior Patient Name	N	48		N/A		


Two Client/Episode Specific Configuration Settings Exist That Are Used To Determine Whether Or Not An ADT Message Should Be Sent		

01)	Exclude Treatment Settings - this allows one to prevent messages from being created if the episode program does not have a valid treatment setting	

	choices are:	
		(I)npatient
		(O)utpatient
		(P)artial

	there is no system default (all ADT messages sent regardless of treatment setting)	


02)	Exclude Program Categories - this allows one to prevent messages from being created if the episode program does not have a valid program category	

	choices are:	
		(P)re-admit
		(A)dmit

	there is no system default (all ADT messages sent regardless)