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Knowledge Base - Article 0050 |
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Billing Interface
UniCharts electronic medical record system exports patient billing information through HL7 data files. All versions of HL7 from 2.3 through 2.6 are supported for billing messages, so as the make the system compatible with as many external systems as possible. If running, an outbound billing interface generates an HL7 billing message every time the encounter form is signed by any user of the system. The message is generated only if that particular encounter has at least one CPT (or EM) code on it. Every exported file contains one DFT P03 message representing a single charge ticket within the EMR system.
Standard Configuration Settings:
The interface must be first be configured before it could be started. To configure, just hit Configure button to open configuration screen and select options from the dropdown menus as appropriate.
The following table explains the setting options available on the above configuration screen:
Setting | Description |
Interface Startup | We recommend selecting Always start with the EMR server startup option. This would eliminate the risk of forgetting to start the interface after EMR startup. Note that an interface must be running in order to write any outgoing DFT messages. There may be situations in which it is desirable to keep it manual, but most of the time auto start is the best option to choose. |
Message to write | Select HL7 DFT P03 option to write billing message through this interface. Note that the DFT messages include patient demographic and insurance information in addition to the charges. |
Message version | This depends on the requirement of the application that would be reading the messages. |
Associated Clinic | As multiple clinics could exist in the same UniCharts EMR installation, you must select which clinic is to send messages through this interface. Note that if there is only one clinic within the system, as it usually goes, there would be just one option available on the dropdown. |
Supervising User | Once you select the clinic, all of its users would become listed on this dropdown. Here, you must select which user would be performing the administrative role for this interface. Select this user carefully as he or she would be the one who will be receiving alerts if there is any problem with generating or saving the messages and will be responsible for taking any further action if needed. |
Folder to write | You can select any directory you want as long as it is not a Windows protected directory and exists on the same machine on which EMR server is running. The selected folder should also be reserved for this purpose. That is, only the UniCharts EMR system should be accessing it to deposit DFT message files and only the single downstream application should be accessing it to read the message files that may have been deposited. |
Limit on writing | The outgoing message files are supposed to be processed and then either deleted or moved from the folder. Here you select the limit on the number of accumulated files after which the interface will stop generating and sending more files to the target folder. |
Advanced Configuration Settings:
The above configuration settings are just enough to start the interface and consequently generate and save DFT messages to the selected folder. However, the messages that will be produced will have segments and fields formatted according to the default interface settings. And this may not be according to the requirements or specifications of downstream application. Fortunately, every outbound UniCharts interface provides an "Advanced" settings option for customizing the segments and fields so as to make the generated message compatible with external applications. Most of the settings available on this window, as shown in the screenshot below, are self explanatory and related to file extension, date formats and optionality of segments. As for the mapping, it facilitates dropdown mapping of gender, marital status, race, relationship and ethnicity HL7 fields with options present on the corresponding dropdown menus on the General form. It also allows fields mapping of insurance carrier and plan related HL7 fields with the corresponding fields on the General form within the EHR system.
Starting the Interface:
Assuming that configuration settings have been saved, the interface is now set to write the HL7 DFT messages. The only thing needed now is to start the interface. If you have selected Always start with the EMR server startup option on the configuration screen as recommended, the interface will start automatically on the next startup of the EMR program. In case you want to start it immediately, this can also be done just by clicking the Start button associated the interface, as shown below.
Monitoring the Interface
UniCharts EMR software provides an easy way to monitor interfaces through a status bar right on the bottom pane of EMR server. The status bar has six square icons on it, three of which represent outgoing while the other three correspond to incoming interfaces. An icon for interface that has not yet been configured has no background color.
Once the configuration settings for an interface are saved, the square icon representing that interface on the status bar turns yellow. A yellow icon means an interface configured but not running.
Once the interface gets started, either manually or automatically at the time of EMR startup, its status icon turns green. A green icon indicates an interface that is running and ready to generate messages.
Finally, if the interface encounters any problem while running, its icon changes to red color. A red icon signifies an interface that is running but for some reason not able to generate or write messages.
It is recommended that EMR administrator periodically monitor the status bar. As status bar is visible on the bottom pane of the EMR server program, it can be checked even without logging into the system. The need to log into the administrator area would only arise if an icon turns red, in which case the administrator must go to the "EDI Interfaces" tab to get more information about the error and resolve it.
Message Composition:
The following HL7 segments are used in outgoing DFT messages.
Segment | Description | Notes |
MSH | Message Header | Always sent by the interface |
EVN | Event Type | Depends on interface setting |
PID | Patient Demographics | Always sent by the interface |
PV1 | Patient Visit | Depends on interface setting |
GT1 | Guarantor Information | Depends on interface setting |
IN1 | Insurance Information | Depends on interface setting |
FT1 | Financial Transaction | Always sent by the interface |
DG1 | Diagnosis | Sent if there are ICD's on form |
Segments Details:
Inclusion:
- A = Always sent by interface.
- S = Sent if available. Applies to both - the constants definable within the interface and the values enterable on the chart form.
- The fields not mentioned are not sent by the interface.
MSH Segment (this segment will always be present) |
Field | Description | Inclusion | Comments |
MSH-00 | Segment Type ID | A | Constant: MSH |
MSH-01 | Field Separator | A | Constant: | (vertical bar) |
MSH-02 | Encoding Characters | A | Constant: ^~\& (carat, tilde, reverse slash, ampersand) |
MSH-03 | Sending Application | S | Default: UCEMR - Value configurable on the Interface |
MSH-04 | Sending Facility | S | Default: UCFAC - Value configurable on the Interface |
MSH-05 | Receiving Application | S | Default: EXAPP - Value configurable on the Interface |
MSH-06 | Receiving Facility | S | Default: EXFAC - Value configurable on the Interface |
MSH-07 | Date/Time of Message | A | <yyyymmddhhmmss> - Format configurable on the Interface |
MSH-09 | Message Type | A | Constant: DFT^P03 |
MSH-10 | Message Control ID | A | A unique value - always 13 characters long |
MSH-11 | Processing ID | A | Constant: P |
MSH-12 | Version ID | A | Constant: As selected on the Interface |
EVN Segment (depending on the interface setting, this segment may or may not be present) |
Field | Description | Inclusion | Comments |
EVN-00 | Segment Type ID | A | Constant: EVN |
EVN-01 | Event Type Code | A | Constant: A28 |
EVN-02 | Recorded Date/Time | A | <yyyymmddhhmmss> - The timestamp when the encounter was signed |
EVN-05 | Operator ID | A | The User ID of user who signed the encounter - can be up to 10 characters long |
PID Segment (this segment will always be present) |
Field | Description | Inclusion | Comments |
PID-00 | Segment Type ID | A | Constant: PID |
PID-01 | Set ID | A | Constant: 1 |
PID-02 | Patient ID | S | Sent blank - Configurable on the Interface so as to include ChartID or MRN |
PID-03 | Patient Identifier List | A | The unique Chart ID of chart within the UniCharts EMR |
PID-04 | Alternate Patient ID | S | Sent blank - Configurable on the Interface so as to include ChartID or MRN |
PID-05 | Patient Name | A | <last>^<first>^<middle>^<suffix> |
PID-07 | Date of Birth | A | <yyyymmdd> - Format configurable on the Interface |
PID-08 | Sex | S | As per dropdown mapping defined on the Interface |
PID-10 | Race | S | As per dropdown mapping defined on the Interface |
PID-11 | Patient Address | S | <street address1>^<street address2>^<city>^<state>^<zip> |
PID-13 | Phone Number - Home | S | <complete number>^PRN^PH^^^<area code>^<phone number>^<extension> |
PID-14 | Phone Number - Business | S | <complete number>^WPN^PH^^^<area code>^<phone number>^<extension> |
PID-16 | Marital Status | S | As per dropdown mapping defined on the Interface |
PID-19 | SSN - Patient | S | Sent with punctuation removed - Configurable on the Interface to send it "as entered" on the chart form |
PID-22 | Ethnic Group | S | As per dropdown mapping defined on Interface (this mapping is only available on MU version) |
PV1 Segment (depending on the interface setting, this segment may or may not be present) |
Field | Description | Inclusion | Comments |
PV1-00 | Segment Type ID | A | Constant: PV1 |
PV1-01 | Set ID | A | Constant: 1 |
PV1-02 | Patient Class | A | Constant: O (O = Outpatient) |
PV1-03 | Patient Location | S | The location code entered on encounter form |
PV1-07 | Attending Provider | A | <ID>^<last>^<first>^<middle>^^^^^^^^^^<assigning facility> - ID is first of the three possible IDs of a user within UniCharts |
PV1-19 | Visit Number | A | The encounter number on the encounter form |
GT1 Segment (depending on the interface setting, this segment may or may not be present) |
Field | Description | Inclusion | Comments |
GT1-00 | Segment Type ID | A | Constant: GT1 |
GT1-01 | Set ID | A | Constant: 1 |
GT1-03 | Guarantor Name | S | <last>^<first>^<middle> - Depends on the option selected on Relation dropdown on the chart form |
GT1-06 | Guarantor Phone - Home | S | <complete number>^PRN^PH^^^<area code>^<phone number>^<extension> |
GT1-08 | Guarantor Date of Birth | S | <yyyymmdd> - Format configurable on the Interface |
GT1-09 | Guarantor Sex | S | As per dropdown mapping defined on the Interface |
GT1-10 | Guarantor Type | S | Constant: H or I (H = Individual, I = Institution) - Depends on the option selected on Relation dropdown on the chart form |
GT1-11 | Guarantor Relationship | S | As per dropdown mapping defined on the Interface |
GT1-21 | Guarantor Organization Name | S | Depends on the option selected on Relation dropdown on the chart form |
IN1 Segment (depending on the interface setting, this segment may or may not be present) |
Field | Description | Inclusion | Comments |
IN1-00 | Segment Type ID | A | Constant: IN1 |
IN1-01 | Set ID | A | Constant: 1 or 2 |
IN1-02 | Insurance Plan ID | S | As per fields mapping defined on the Interface |
IN1-03 | Insurance Company ID | S | As per fields mapping defined on the Interface |
IN1-04 | Insurance Company Name | S | As per fields mapping defined on the Interface |
IN1-05 | Insurance Company Address | S | <street address>^^<city>^<state>^<zip> |
IN1-07 | Insurance Company Phone | S | <complete number>^^^^^<area code>^<phone number>^<extension> |
IN1-08 | Group Number | S | Sent with punctuation removed - Configurable on the Interface to send it "as entered" on the chart form |
IN1-13 | Plan Expiration Date | S | <yyyymmdd> - Format configurable on the Interface |
IN1-14 | Authorization Information | S | As entered on the chart form |
IN1-15 | Plan Type | S | As per fields mapping defined on the Interface |
IN1-16 | Name of Insured | S | <last>^<first>^<middle> |
IN1-17 | Insured’s Relationship | S | As per dropdown mapping defined on the Interface |
IN1-18 | Insured’s Date of Birth | S | <yyyymmdd> - Format configurable on the Interface |
IN1-36 | Policy Number | S | Sent with punctuation removed - Configurable on the Interface to send it "as entered" on the chart form |
IN1-43 | Insured’s Sex | S | As per dropdown mapping defined on the Interface |
FT1 Segment (this segment will always be present) |
Note: There will be one FT1 segment per every CPT or EM code entered on the encounter form. For example, if there is one EM and two CPT codes, there will be three FT1 segments |
Field | Description | Inclusion | Comments |
FT1-00 | Segment Type ID | A | Constant: FT1 |
FT1-01 | Set ID | A | Constant: Sequence number starting from 1 |
FT1-02 | Transaction ID | A | The unique number representing the charge ticket within the EHR software |
FT1-04 | Transaction Date | A | <yyyymmdd> |
FT1-06 | Transaction Type | A | Constant: CG |
FT1-10 | Transaction Quantity | S | <units> |
FT1-16 | Patient Location | S | The location code entered on encounter form. The same value as in PV1-03 |
FT1-19 | Diagnosis Codes | S | <code>^<description>~<code>^<descriptionr> ... up to four codes - These same codes are also sent as DG1 segments |
FT1-20 | Performing Provider | A | <ID>^<last>^<first>^<middle>^^^^^^^^^^<assigning facility> - ID is first of the three possible IDs of a user within UniCharts - The same value as in PV1-07 |
FT1-25 | Procedure Code | A | <code>^<description> |
FT1-26 | Modifiers | S | <code> - up to one modifier per procedure (not available in HL7 version 2.3) |
DG1 Segment (will be present only if there are ICDs on the encounter form) |
Note: The DG1 segments are included in the scope of message and NOT as the children of FT1 segments - upto four DG1 segments may be included. These same codes are also sent in FT1-19 and may be retreived from there in case target application does not support DG1 segments. |
Field | Description | Inclusion | Comments |
DG1-00 | Segment Type ID | A | Constant: DG1 |
DG1-01 | Set ID | A | Constant: Sequence number starting from 1 |
DG1-03 | Diagnosis Code | S | <code> |
DG1-04 | Diagnosis Description | S | <description> |
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DISCLAIMER: THE OUTGOING INTERFACES ARE COMPLIMENTARY AND PROVIDED AT NO CHARGE. IT IS USERS’ RESPONSIBILITY TO CONFIGURE AN OUTGOING INTERFACE AND MAKE IT WORK WITH THE INTENDED EXTERNAL APPLICATION. AS BASIC KNOWLEDGE OF HL7 AND TARGET APPLICATION’S REQUIREMENTS WOULD BE NEEDED, THE TECHNICAL SUPPORT PERSONNEL AT THE TARGET APPLICATION MAY BE IN THE BEST POSITION TO HELP YOU CONFIGURE THE INTERFACE USING INSTRUCTIONS PROVIDED IN THIS DOCUMENT.
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