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Sheet 1: Table of Contents
| athenahealth HL7 Native Data Structure Thank you for reviewing the athenahealth native HL7 data structure. This document identifies the data athenahealth capture by default and the fields/components in which they are expected (inbound messages to athena) and sent (outbound messages from athena). By default athenahealth will not send or process any field listed as “*Not Specified*” or that is not included in the specification. Version: 21.7 Last Updated: 7/8/2021 |
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| Table of Contents | |||||||
| Outbound Patients | Provides the layout of the HL7 message type(s) that athena uses by default to send New Patient and Patient Update messages. | ||||||
| Inbound Patients | Provides the layout of the HL7 message type(s) that athena expects by default to receive New Patient and Patient Update messages. | ||||||
| Inbound Admit & Discharge | Provides the layout of the HL7 message type(s) that athena expects by default to process Admit and Discharge events into athenaNet. | ||||||
| Sample Messages | Provides sample ADT messages. | ||||||
| Common Use Case Sample Messages | Provides sample ADT messages for our Common Use Case Interfaces | ||||||
| Minimum Requirements - Inbound | Lists the minimum required elements in order to create a Patient, Appointment, Charge, and Insurance in athena from an HL7 message. Please see Interface Scoping Questionnaires (ISQ) for more information. | ||||||
| Message Layout by Category | For each of the message categories that athena supports, this tab provides a quick reference segment breakdown - required segments, optional segments, repeatable segments, and the expected ordering of the segments. | ||||||
| Change Log | Document version history. | ||||||
| Table of Contents | ||||||||
| MSG Category | Direction | MSG TYPE | Segment | Field | Component | athena Field | Notes | Sent by Default |
| ADT | OUT | A04,A08,A28,A31 | MSH | 1 | 1 | Field Separator | In the MSH segment only, the pipe delimiter '|' that immediately follows the 'MSH' segment header is considered the first field of the segment. | Yes |
| ADT | OUT | A04,A08,A28,A31 | MSH | 2 | 1 | Encoding Characters | athena sends the HL7 recommended values of ^~\&. These are the component separator, repitition separator, escape character, and subcomponent separator, respectively. | Yes |
| ADT | OUT | A04,A08,A28,A31 | MSH | 3 | 1 | Sending Application | athena sends 'ATHENANET'. | Yes |
| ADT | OUT | A04,A08,A28,A31 | MSH | 4 | 1 | Context ID | This is the practice's unique identifier within athena. | Yes |
| ADT | OUT | A04,A08,A28,A31 | MSH | 4 | 2 | Practice's Name | Up to 40 characters will be sent in this component. | Yes |
| ADT | OUT | A04,A08,A28,A31 | MSH | 4 | 3 | Provider Group's ID | Yes | |
| ADT | OUT | A04,A08,A28,A31 | MSH | 4 | 4 | Provider Group's Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | MSH | 5 | 1 | Interface Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | MSH | 6 | 1 | Trading Partner Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | MSH | 7 | 1 | Date/Time of Message | In format YYYYMMDDHH24MM. | Yes |
| ADT | OUT | A04,A08,A28,A31 | MSH | 8 | 1 | SUBSCRIPTION.MESSAGETYPEGROUP | Yes | |
| ADT | OUT | A04,A08,A28,A31 | MSH | 9 | 1 | Message Category | Yes | |
| ADT | OUT | A04,A08,A28,A31 | MSH | 9 | 2 | Message Type | Yes | |
| ADT | OUT | A04,A08,A28,A31 | MSH | 10 | 1 | Message ID | This is the message control number generated by athenaNet and should be acknowledged by the receiving application if HL7 ACKs are enabled. | Yes |
| ADT | OUT | A04,A08,A28,A31 | MSH | 11 | 1 | Processing ID | The default value is 'T' but athena can also send 'P' or 'D'. | Yes |
| ADT | OUT | A04,A08,A28,A31 | MSH | 12 | 1 | HL7 Version | Yes | |
| ADT | OUT | A04,A08,A28,A31 | MSH | 13 - 21 | ** NOT SPECIFIED ** | These fields are not specified / not used by default | ||
| ADT | OUT | A04,A08,A28,A31 | EVN | 1 | 1 | Message Type | Yes | |
| ADT | OUT | A04,A08,A28,A31 | EVN | 2 | 1 | Trigger Event Timestamp | In format YYYYMMDDHH12MM. | Yes |
| ADT | OUT | A04,A08,A28,A31 | EVN | 3 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | EVN | 4 | 1 | Event Reason Code | ||
| ADT | OUT | A04,A08,A28,A31 | EVN | 5 | 1 | Created by: Username | athenaNet username of the user that triggered the message. | Yes |
| ADT | OUT | A04,A08,A28,A31 | EVN | 6 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 1 | 1 | Set ID - PID | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 2 | 1 | Patient's athenaNet Enterprise ID | This is a numeric identifier. For clients with multiple Provider Groups in athena, the patient's Enterprise ID is common for the entire tablespace, across all Provider Groups. If there is only one Provider Group in the tablespace then patients would not have Enterprise IDs and this field would just contain the athena patient ID. This field can be configured to send other IDs as well. | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 2 | 2 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 2 | 3 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 2 | 4 | Assigning Authority | If configured, the 4th component of this field will contain the assigning authority, specifying the ID in the first component | |
| ADT | OUT | A04,A08,A28,A31 | PID | 3 | 1 | Patient's athenaNet Enterprise ID | This is a numeric identifier. For clients with multiple Provider Groups in athena, the patient's Enterprise ID is common for the entire tablespace, across all Provider Groups. If there is only one Provider Group in the tablespace then patients would not have Enterprise IDs and this field would just contain the athena patient ID. This field can be configured to send other IDs as well. | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 3 | 2 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 3 | 3 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 3 | 4 | Assigning Authority | If configured, the 4th component of this field will contain the assigning authority, specifying the ID in the first component | |
| ADT | OUT | A04,A08,A28,A31 | PID | 4 | 1 | Patient's athenaNet ID | The patient's athenaNet ID is specific to a Provider Group for clients with multiple Provider Groups. This field can be configured to send other IDs as well. | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 4 | 2 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 4 | 3 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 4 | 4 | Assigning Authority | If configured, the 4th component of this field will contain the assigning authority, specifying the ID in the first component | |
| ADT | OUT | A04,A08,A28,A31 | PID | 5 | 1 | Patient's Last Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 5 | 2 | Patient's First Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 5 | 3 | Patient's Middle Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 5 | 4 | Patient's Name Suffix | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 6 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 7 | 1 | Patient's Date of Birth | In format YYYYMMDD. | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 8 | 1 | Patient's Sex | athena sends either 'F' or 'M'. | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 9 | 1 | Patient's Preferred Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 10 | 1 | Patient's Race ID | Please refer to athenaNet Global Tables document. Athena sends CDC_UNIQUEIDENTIFIER by default. | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 10 | 2 | Patient's Race Name | Please refer to athenaNet Global Tables document. | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 11 | 1 | Patient's Street Address | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 11 | 2 | Patient's Street Address (ctd) | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 11 | 3 | Patient's Address City | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 11 | 4 | Patient's Address State | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 11 | 5 | Patient's Address Zip | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 11 | 6 | Patient's Address Country Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 12 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 13 | 1 | Patient's Phone Number - HOME | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 13 | 2 | Patient's Phone Number - WORK | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 13 | 3 | Patient's Phone Number - WORK | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 13 | 4 | Patient's Phone Number - MOBILE | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 13 | 5 | Patient's Email | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 14 | 1 | Patient's Phone Number - WORK | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 15 | 1 | Patient's Primary Language Code | Please refer to athenaNet Global Tables document. Athena sends ISO6392CODE by default. | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 15 | 2 | Patient's Primary Language Name | Please refer to athenaNet Global Tables document. | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 16 | 1 | Patient's Marital Status Identifier | A=Separated, D=Divorced, M=Married, S=Single, W=Widowed, U=Unknown | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 17 | 1 | Religion Name | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 18 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 19 | 1 | Patient's SSN | Patient SSN; 9 digits, no dashes, in ######### format | Yes |
| ADT | OUT | A04,A08,A28,A31 | PID | 20 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 21 | 1 | PATIENT.EMPLOYERNAME | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 22 | 1 | Patient's Ethnic Group ID | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 22 | 2 | Patient's Ethnic Group Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 23 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 24 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 25 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 26 | 1 | Former Last Name | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 27 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 28 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PID | 29 | 1 | Patient's Death Date | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PID | 30 | 1 | Patient Death Indicator | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 1 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 2 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 3 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 4 | 1 | PCP's ID | Insurance PCP, if listed | Yes |
| ADT | OUT | A04,A08,A28,A31 | PD1 | 4 | 2 | PCP's Last Name | Insurance PCP, if listed | Yes |
| ADT | OUT | A04,A08,A28,A31 | PD1 | 4 | 3 | PCP's First Name | Insurance PCP, if listed | Yes |
| ADT | OUT | A04,A08,A28,A31 | PD1 | 4 | 4 | PCP's Middle Initial | Insurance PCP, if listed | Yes |
| ADT | OUT | A04,A08,A28,A31 | PD1 | 5 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 6 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 7 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 8 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 9 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 10 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 11 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PD1 | 12 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | NK1 | 1 | 1 | Set ID - NK1 | Yes | |
| ADT | OUT | A04,A08,A28,A31 | NK1 | 2 | 1 | Contact Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | NK1 | 3 | 1 | Relationship to Patient | Yes | |
| ADT | OUT | A04,A08,A28,A31 | NK1 | 4 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | NK1 | 4 | 2 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | NK1 | 4 | 3 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | NK1 | 4 | 4 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | NK1 | 4 | 5 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | NK1 | 5 | 1 | Contact Phone Number - HOME | Yes | |
| ADT | OUT | A04,A08,A28,A31 | NK1 | 5 | 2 | Contact Phone Number - MOBILE | ||
| ADT | OUT | A04,A08,A28,A31 | NK1 | 6 | 1 | Contact Phone Number - WORK | Yes | |
| ADT | OUT | A04,A08,A28,A31 | NK1 | 7 | 1 | Contact Role/Type | C = Emergency Contact; N = Next of Kin | Yes |
| ADT | OUT | A04,A08,A28,A31 | NK1 | 8 - 39 | ** NOT SPECIFIED ** | These fields are not specified / not used by default | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 1 | 1 | Set ID - PV1 | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 2 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 3 | 1 | Patient's Primary Department ID | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 3 | 2 | Patient's Primary Department Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 3 | 3 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 3 | 4 | Patient's Primary Department Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 4 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 5 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 6 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 7 | 1 | Usual Provider's NPI Number (else athena ID) | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 7 | 2 | Usual Provider's Last Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 7 | 3 | Usual Provider's First Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 7 | 4 | Usual Provider's Middle Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 8 | 1 | Referring Provider's NPI Number (else Provider ID) | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 8 | 2 | Referring Provider's Last name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 8 | 3 | Referring Provider's First Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 8 | 4 | Referring Provider's Middle Initial | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 9 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 10 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 11 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 12 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 13 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 14 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 15 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 16 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 17 | 1 | Usual Provider's NPI Number (else athena ID) | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 17 | 2 | Usual Provider's Last Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 17 | 3 | Usual Provider's First Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 17 | 4 | Usual Provider's Middle Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | PV1 | 18 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 19 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | PV1 | 20 - 52 | ** NOT SPECIFIED ** | These fields are not specified / not used by default | ||
| ADT | OUT | A04,A08,A28,A31 | PV2 | 1 - 49 | ** NOT SPECIFIED ** | This entire segment is not specified / not used by default | ||
| ADT | OUT | A04,A08,A28,A31 | DB1 | 1 - 8 | ** NOT SPECIFIED ** | This entire segment is not specified / not used by default | ||
| ADT | OUT | A04,A08,A28,A31 | ROL | 1 - 12 | ** NOT SPECIFIED ** | This entire segment is not specified / not used by default | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 1 | 1 | Set ID - GT1 | Segment Count Identifier | Yes |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 2 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 3 | 1 | Guarantor's Last Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 3 | 2 | Guarantor's First Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 3 | 3 | Guarantor's Middle Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 3 | 4 | Guarantor's Name Suffix | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 4 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 5 | 1 | Guarantor's Address 1 | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 5 | 2 | Guarantor's Address 2 | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 5 | 3 | Guarantor's Address City | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 5 | 4 | Guarantor's Address State | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 5 | 5 | Guarantor's Address Zip | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 5 | 6 | Guarantor's Address Country Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 6 | 1 | Guarantor's Phone Number | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 6 | 2 | Guarantor's Email Address | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 7 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 8 | 1 | Guarantor's Date of Birth | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 9 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 10 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 11 | 1 | Patient's Relationship to Guarantor | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 12 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 13 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 14 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 15 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 16 | 1 | Guarantor's Employer Name | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 17 | 1 | Guarantor's Employer Street Address 1 | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 17 | 2 | Guarantor's Employer Street Address 2 | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 17 | 3 | Guarantor's Employer Address City | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 17 | 4 | Guarantor's Employer Address State | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 17 | 5 | Guarantor's Employer Address Zip Code | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 18 | 1 | Guarantor's Employer Phone Number | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 19 - 44 | ** NOT SPECIFIED ** | These fields are not specified / not used by default | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 45 | 1 | Patient's Emergency Contact Name | <family name>^<given name>^<middle initial or name> | Yes |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 45 | 2 | PATIENT.CONTACTNAME | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 46 | 1 | Patient's Emergency Contact Phone Number - HOME | contact phone, in (xxx)yyy-zzzz format | Yes |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 46 | 2 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 47 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 48 | 1 | Emergency Contact's Relationship to Patient | Yes | |
| ADT | OUT | A04,A08,A28,A31 | GT1 | 49 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 50 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 51 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 52 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 53 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 54 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | GT1 | 55 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 1 | 1 | Set ID - IN1 | 1 - for primary insurance, 2 for secondary (if present), 3 for tertiary (if present) | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 2 | 1 | Insurance Package ID | <athenaNet’s globally assigned insurancepackageid for this insurance> | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 2 | 2 | Insurance Package Name | <athenaNet’s insurance name> | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 3 | 1 | Insurance Reporting Category ID | Usually, same as IN1.2 | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 3 | 2 | Insurance Company ID | <athenaNet’s globally assigned insurancepackageid for this insurance>^<athenaNet’s insurance name> Max length for insurance package name is 100 characters. | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 4 | 1 | Insurance Company Name | athenaNet's insurance name | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 5 | 1 | Insurance Company Address 1 | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 5 | 2 | Insurance Company Address 2 | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 5 | 3 | Insurance Company Address City | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 5 | 4 | Insurance Company Address State | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 5 | 5 | Insurance Company Address Zip | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 6 | 1 | Insurance Company Contact Name | <insurance contact lastname>^<insurance contact firstname> | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 6 | 2 | PATIENTINSURANCELIST[i].INSURANCECONTACTNAME | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 7 | 1 | Insurance Company Phone Number | insurance main contact phone, in (xxx)yyy-zzzz format | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 8 | 1 | Policy/group number | Mapped to PATIENTINSURANCE.POLICYNUMBER. The group ID/number. | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 9 | 1 | Insurance Group Name | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 10 | 1 | Insured's Group Employee ID | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 11 | 1 | Insured's Group Employer Name | Mapped to PATIENTINSURANCE.EMPLOYERNAME | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 12 | 1 | Plan Effective Date | Mapped to PATIENTINSURANCE.ISSUEDATE, in YYYYMMDD format. | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 13 | 1 | Plan Expiration Date | Mapped to PATIENTINSURANCE.EXPIRATIONDATE, in YYYYMMDD format. | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 14 | 1 | PATIENTINSURANCELIST[i].REFERRALAUTHNUMBER | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 15 | 1 | Plan Type | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 16 | 1 | Insured's Last Name | Policy Holder information | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 16 | 2 | Insured's First Name | Policy Holder information | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 16 | 3 | Insured's Middle Name | Policy Holder information | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 17 | 1 | Patient's Relationship to Insured | See Relationship tab of athenaNet Global Tables document for all options | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 18 | 1 | Insured's Date of Birth | Mapped to PATIENTINSURANCE.INSUREDDOB, in YYYYMMDD format.; "Policy Holder" Information | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 19 | 1 | Insured's Street Address 1 | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 19 | 2 | Insured's Street Address 2 | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 19 | 3 | Insured's Address City | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 19 | 4 | Insured's Address State | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 19 | 5 | Insured's Address Zip Code | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 19 | 6 | Insured's Address Country Code ID | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 19 | 7 | Insured's SSN | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 20 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 21 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 22 | 1 | Coordination of Benefits Priority | Mapped to PATIENTINSURANCE.SEQUENCENUMBER (also determines whether this patientinsurance record is PRIMARYPATIENTINSURANCEID or SECONDARYPATIENTINSURANCEID on the claim). If null, indicates a case-policy insurance. Example, "1" or "2." | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 23 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 24 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 25 | 1 | Report of Eligibility Flag | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 26 | 1 | Report of Eligibility Date | Yes | |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 27 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 28 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 29 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 30 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 31 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 32 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 33 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 34 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 35 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 36 | 1 | Member ID/certification number | Mapped to PATIENTINSURANCE.IDNUMBER; the member's insurance ID/number. Please note that athenahealth does not currently send the policy holder ID in IN1-49, please discuss with your project representative if you need this data. | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 37 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 38 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 39 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 40 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 41 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 42 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 43 | 1 | Insured's Sex | Mapped to PATIENTINSURANCE.INSUREDSEX. F,M,O [other], U [unknown] | Yes |
| ADT | OUT | A04,A08,A28,A31 | IN1 | 44 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 45 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 46 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 47 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 48 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN1 | 49 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | IN2 | 1- 72 | ** NOT SPECIFIED ** | This entire segment is not specified / not used by default | ||
| ADT | OUT | A04,A08,A28,A31 | IN3 | 1 - 25 | ** NOT SPECIFIED ** | This entire segment is not specified / not used by default | ||
| ADT | OUT | A04,A08,A28,A31 | ACC | 1 | 1 | Accident Date/Time | Yes | |
| ADT | OUT | A04,A08,A28,A31 | ACC | 2 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | ACC | 3 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | ACC | 4 | 1 | ** NOT SPECIFIED ** | ||
| ADT | OUT | A04,A08,A28,A31 | ACC | 5 | 1 | VISITCASE.RELATEDTOEMPLOYMENTYN | Yes | |
| ADT | OUT | A04,A08,A28,A31 | ACC | 6 | 1 | ** NOT SPECIFIED ** |
| Table of Contents | ||||||||
| MSG Category | Direction | MSG TYPE | Segment | Field | Component | athena Field / Expected Value | Notes | Expected by Default |
| ADT | IN | A04,A08,A28,A31 | MSH | 1 | 1 | Field Separator | In the MSH segment only, the pipe delimiter '|' that immediately follows the 'MSH' segment header is considered the first field of the segment. | |
| ADT | IN | A04,A08,A28,A31 | MSH | 2 | 1 | ^~\& | athena expects the HL7 recommended values of ^~\&. These are the component separator, repitition separator, escape character, and subcomponent separator, respectively. | |
| ADT | IN | A04,A08,A28,A31 | MSH | 3 | 1 | Sending Application | Source_Vendor | Yes |
| ADT | IN | A04,A08,A28,A31 | MSH | 4 | 1 | Sending Facility | Source_Vendor | |
| ADT | IN | A04,A08,A28,A31 | MSH | 5 | 1 | Receiving Application | Standard Format (e.g. 'ATHENANET') | |
| ADT | IN | A04,A08,A28,A31 | MSH | 6 | 1 | athenaNet Context ID | ||
| ADT | IN | A04,A08,A28,A31 | MSH | 6 | 2 | Context Name | ||
| ADT | IN | A04,A08,A28,A31 | MSH | 7 | 1 | Message Timestamp | Standard Format | |
| ADT | IN | A04,A08,A28,A31 | MSH | 8 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | MSH | 9 | 1 | Message Category | Standard Format | |
| ADT | IN | A04,A08,A28,A31 | MSH | 9 | 2 | Message Type | Standard Format | |
| ADT | IN | A04,A08,A28,A31 | MSH | 10 | 1 | Message ID | Standard Format | |
| ADT | IN | A04,A08,A28,A31 | MSH | 11 | 1 | Processing ID | Standard Format | |
| ADT | IN | A04,A08,A28,A31 | MSH | 12 | 1 | HL7 Version | Standard Format | |
| ADT | IN | A04,A08,A28,A31 | MSH | 13 - 21 | 1 | ** NOT SPECIFIED ** | These fields are not specified / not used by default | |
| ADT | IN | A04,A08,A28,A31 | EVN | 1 | 1 | Event Type (Message Type) | Standard Format | |
| ADT | IN | A04,A08,A28,A31 | EVN | 2 | 1 | Recorded/Creation Date | Standard Format | |
| ADT | IN | A04,A08,A28,A31 | EVN | 3 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | EVN | 4 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | EVN | 5 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | EVN | 6 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 1 | 1 | Set ID - PID | ||
| ADT | IN | A04,A08,A28,A31 | PID | 2 | 1 | Patient ID | Used for patient-matching. The specific ID (such as an external ID, athenaNet Patient ID, athenaNet Enterprise ID) can be configured during scoping | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 2 | 2 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 2 | 3 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 2 | 4 | Assigning Authority | If configured, the Assigning Authority is mapped from the 4th component of the field to specify the correct ID being sent. This is required if the PID field will repeat. | |
| ADT | IN | A04,A08,A28,A31 | PID | 3 | 1 | Patient ID | Used for patient-matching. The specific ID (such as an external ID, athenaNet Patient ID, athenaNet Enterprise ID) can be configured during scoping | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 3 | 2 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 3 | 3 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 3 | 4 | Assigning Authority | If configured, the Assigning Authority is mapped from the 4th component of the field to specify the correct ID being sent. This is required if the PID field will repeat. | |
| ADT | IN | A04,A08,A28,A31 | PID | 4 | 1 | Patient ID | Used for patient-matching. The specific ID (such as an external ID, athenaNet Patient ID, athenaNet Enterprise ID) can be configured during scoping | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 4 | 2 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 4 | 3 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 4 | 4 | Assigning Authority | If configured, the Assigning Authority is mapped from the 4th component of the field to specify the correct ID being sent. This is required if the PID field will repeat. | |
| ADT | IN | A04,A08,A28,A31 | PID | 5 | 1 | Patient's Last Name | Standard Format | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 5 | 2 | Patient's First Name | Standard Format | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 5 | 3 | Patient's Middle Initial | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 5 | 4 | Patient's Name Suffix | Standard Format | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 6 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 7 | 1 | Patient's Date of Birth | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 8 | 1 | Patient's Sex | Male/Female | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 9 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 10 | 1 | Patient's Race Code | Must be mapped to athena global value | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 10 | 2 | Patient's Race Name | "Foreign Value" associated with mapping | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 11 | 1 | Address Line 1 | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 11 | 2 | Address Line 2 | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 11 | 3 | Patient's Address City | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 11 | 4 | Patient's Address State | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 11 | 5 | Patient's Address Zip | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 11 | 6 | Patient's Address Country Name | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 12 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 13 | 1 | Patient's Phone Number - Home | Format: #########, (###)###-####, ###-###-#### | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 13 | 2 | Patient's Phone Number - Mobile | Format: #########, (###)###-####, ###-###-#### | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 13 | 3 | Patient's Email | Please be aware if you update a patient’s email address in Quickview, they’ll need to re-register to your organization’s Patient Portal at the new email address and will not be able to access that Patient Portal using the athenahealth account associated with the previous email address. An email invitation to the Patient Portal is automatically sent to the new email address when an email is updated for an existing portal user. | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 13 | 4 | Patient's Phone Number - MOBILE | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 13 | 5 | Patient's Email | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 14 | 1 | Patient's Phone Number - Work | Format: #########, (###)###-####, ###-###-#### | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 15 | 2 | Patient's Primary Language Code | Must be mapped to athena Global value | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 15 | 3 | Patient's Primary Language Name | "Foreign Value" associated with mapping | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 16 | 1 | Patient's Marital Status Code | Must be mapped to athena Global value | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 16 | 2 | Patient's Marital Status Information | "Foreign Value" associated with mapping | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 17 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 18 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 19 | 1 | Patient's SSN | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 20 | 1 | PATIENT.LICENSESTATEID/ PATIENT.LICENSENUMBER | Yes | |
| ADT | IN | A04,A08,A28,A31 | PID | 21 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PID | 22 | 1 | Patient's Ethnic Group ID | Must be mapped to athena Global value | Yes |
| ADT | IN | A04,A08,A28,A31 | PID | 22 | 2 | Patient's Ethnic Group Name | "Foreign Value" associated with mapping | Yes |
| ADT | IN | A04,A08,A28,A31 | PV1 | 1 | 1 | Set ID - PV1 | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 2 | 1 | CUSTOM.ISOUTPATIENTVISITYN | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 3 | 1 | Patient's Primary Department Name | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 4 | 1 | CUSTOM.ISEDVISITYN | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 5 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 6 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 7 | 1 | Primary Provider's ID | the athenaNet MX engine will try to match this ID to an NPI in the appropriate client's tablespace. If that match fails it will attempt to match to an athenaNet provider ID, and if that also fails then a mapping task will be triggered to associate the foreign ID to an athenaNet provider ID. | Yes |
| ADT | IN | A04,A08,A28,A31 | PV1 | 7 | 2 | Primary Provider's Last Name | Yes | |
| ADT | IN | A04,A08,A28,A31 | PV1 | 7 | 3 | Primary Provider's First Name | Yes | |
| ADT | IN | A04,A08,A28,A31 | PV1 | 7 | 4 | Primary Provider's Middle Initial | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 8 | 1 | Referring Provider's ID | the athenaNet MX engine will try to match this ID to an NPI in the appropriate client's tablespace. If that match fails it will attempt to match to an athenaNet provider ID, and if that also fails then a mapping task will be triggered to associate the foreign ID to an athenaNet provider ID. | |
| ADT | IN | A04,A08,A28,A31 | PV1 | 8 | 2 | Referring Provider's Last Name | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 8 | 3 | Referring Provider's First Name | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 8 | 4 | Referring Provider's Middle Initial | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 9 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 10 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 11 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 12 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 13 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 14 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 15 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 16 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 17 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 18 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 19 - 43 | ** NOT USED ** | These fields are not specified / not used by default | ||
| ADT | IN | A04,A08,A28,A31 | PV1 | 44 | 1 | COMMONFIELDS.CLAIM.FROMHOSPITALIZATIONDATE | Technically this is populated in COMMONFIELDS because it needs to be conditionally used in TransformCanonical in code | Yes |
| ADT | IN | A04,A08,A28,A31 | PV2 | 1- 49 | 1 | ** NOT USED ** | This entire segment is not specified / not used by default | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 1 | 1 | SET ID - GT1 | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 2 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 3 | 1 | Guarantor Last Name | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 3 | 2 | Guarantor First Name | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 3 | 3 | Guarantor Middle Initial | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 3 | 4 | Guarantor Name Suffix | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 4 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 5 | 1 | Guarantor's Address Line 1 | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 5 | 2 | Guarantor's Address Line 2 | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 5 | 3 | Guarantor's Address City | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 5 | 4 | Guarantor's Address State | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 5 | 5 | Guarantor's Address Zip | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 5 | 6 | Guarantor's Address Country | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 6 | 1 | Guarantor Phone Number | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 7 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 8 | 1 | Guarantor DOB | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 9 | 1 | PATIENT.RPSEX | Guarantor Sex, Not Visible on Portal | Yes |
| ADT | IN | A04,A08,A28,A31 | GT1 | 10 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 11 | 1 | Patient's Relationship to Guarantor ID | Must be mapped to athena Global value | Yes |
| ADT | IN | A04,A08,A28,A31 | GT1 | 12 | 1 | Guarantor SSN | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 13 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 13 | 2 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 13 | 3 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 14 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 15 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 16 | 1 | Guarantor's Employer Foreign ID | Must be mapped to athena Global value | Yes |
| ADT | IN | A04,A08,A28,A31 | GT1 | 16 | 2 | Guarantor's Employer Foreign Information | "Foreign Value" associated with mapping | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 17 - 44 | ** NOT USED ** | These fields are not specified / not used by default | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 45 | 1 | Patient's Emergency Contact Name (Last) | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 45 | 1 | Patient's Emergency Contact Name (First) | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 46 | 1 | Patient's Emergency Contact Phone Number - HOME | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 47 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | GT1 | 48 | 1 | Emergency Contact's Relationship to Patient | Yes | |
| ADT | IN | A04,A08,A28,A31 | GT1 | 49 | 1 | Patient Occupation | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 1 | 1 | Set ID - IN1 | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 2 | 1 | Insurance Package Code | IN1.2 + IN1.4 + IN1.5 together form the Foreign ID that must be mapped to an athenaNet global insurance package. | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 3 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 4 | 1 | Insurance Package Name | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 5 | 1 | Insurance Package Address 1 | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 5 | 2 | Insurance Package Address 2 | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 5 | 3 | Insurance Package Address City | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 5 | 4 | Insurance Package Address State | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 5 | 5 | Insurance Package Address Zip | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 6 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 7 | 1 | Insurance Package Phone Number | Value For Mapping to athena Global Insurance Tables | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 8 | 1 | Insurance Group Number | External Value for Code | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 9 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 10 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 11 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 12 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 13 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 14 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 15 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 16 | 1 | Insured's Last Name | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 16 | 2 | Insured's First Name | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 16 | 3 | Insured's Middle Initial | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 17 | 1 | Patient's Relationship to Insured External ID | Value For Mapping to athena Global Mapping Values | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 17 | 2 | Relationship to Insured External Information | External Value for Code | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 18 | 1 | Insured's Date of Birth | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 19 | 1 | Insured's Street Address Line 1 | Standard Format | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 19 | 2 | Insured's Street Address Line 2 | Standard Format | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 19 | 3 | Insured's Address City | Standard Format | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 19 | 4 | Insured's Address State | Standard Format | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 19 | 5 | Insured's Address Zip Code | Standard Format | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 20 | 1 | PATIENTINSURANCELIST[i].ASSIGNMENTOFBENEFITS | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 21 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 22 | 1 | Coordination of Benefits Priority/Sequence Number | Ranking 1-3 | Yes |
| ADT | IN | A04,A08,A28,A31 | IN1 | 23 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 24 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 25 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 26 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 27 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 28 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 29 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 30 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 31 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 32 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 33 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 34 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 35 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 36 | 1 | Member ID/certification number | Yes | |
| ADT | IN | A04,A08,A28,A31 | IN1 | 37 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 38 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 39 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 40 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 41 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 42 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN1 | 43 | 1 | Insured's Sex | Format: M/F or Male/Female | Yes |
| ADT | IN | A04,A08,A28,A31 | IN2 | 1 | 1 | ** NOT USED ** | ||
| ADT | IN | A04,A08,A28,A31 | IN2 | 1- 72 | ** NOT SPECIFIED ** | This entire segment is not specified / not used by default | ||
| ADT | IN | A04,A08,A28,A31 | IN3 | 1 - 25 | ** NOT SPECIFIED ** | This entire segment is not specified / not used by default |
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