Finance/Accounting Specifications

Sequel Systems, Inc.

Purpose

This document defines the interface linking between two systems. The two systems will be
the common process through which the systems will communicate, allowing to exchange
information. This interface conforms to the application layer definition of the Health Level 7 (HL7)
interface specification Version 2.3. HL7 is an application level protocol for the electronic exchange
or transfer of data in the healthcare environment.

Communication Protocol

Sequel Systems, Inc. has defined TCP/IP as their standard communication protocol. As a
result Sequel Systems adopted the HL7 lower layer protocol format for message receiving.

HL7 Messages Format

Accounting message segments are

SEGMENTS SEGMENT DESCRIPTION

MSH Message Header

PID Patient Identification
PV1 Patient Visit Information
[{IN1}] Insurance Information
[{IN2}] Insurance Additional Information
[ZLA] Insured’s Lawyer information
[GT1] Guarantor Information
[ZSC] Patient’s School information
[DB1] Patient Disability Information
{FT1} Financial Transaction
[ACC] Accident Information

Key: [ ] = Optional Segments

{ } = 1+ occurrences, repeated

Following profiles must be maintained on both sending and receiving systems. These
profiles must be synchronized in order for all data items to be interpreted correctly.

Location
Provider
Referring Provider
Responsible Party
School
Plan
Plan Address
Employer
Lawyer

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 MSH – Message Header Segment

The MSH segment defines the source, destination, message type and some specific fields of the
segment. This is message header used in all message segments.

MSH Segment

Sequence Length Type Required Field Name Note

Number /Optional
1 1 ST R Field Separator 1
2 5 ST R Encoding Characters (“|^~\&”) 1
3 25 ST O Sending Application
4 25 ST O Sending Facility
5 25 ST O Receiving Application
6 25 ST O Receiving Facility
7 12 TS O Date/Time of Message
8 N/A Security
9 7 CM R Message Type 2
10 20 ST R Message Control ID
11 1 PT R Processing ID
12 8 ID R Version ID
13 N/A Sequence Number
14 N/A Continuation Pointer

1) The characters that are used by default are a “|” for the field separator, “^” for the
component separator, “&” for the sub-component separator and “~” for repetition separator
and “\” for the escape character.

2) The event codes supported by SequelMed are:

P01 Add patient’s account

P03 Post detail financial transactions (Create visit charges)
P05 Update patient’s account

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 P01 and P05
Data are sent from some application (usually a Registration or an ADT system) for example, to the
patient accounting or financial system to establish an account for a patient’s billing/accounts
receivable record. Many of the segments associated with this event are optional.
The A01 (admit/visit notification) event can notify systems of the creation of an account as well as
notify of a patient's arrival in the healthcare facility. In order to create a new account without
notifying systems of a patient's arrival, use the P01 trigger event.
SequelMed uses P01 event to add a new account that did not exist before, not to update an existing
account. The P05 (update account) event used to update an existing account.

PID – Patient Identification Segment

The PID segment is used by all applications as the primary means of communicating patient
identification information. This segment contains permanent patient identifying and demographic
information that, for the most part, is not likely to change frequently.

PID Segment
Sequence Length Type Required SequelMed HL7 Note
Number /Optional Field Name Field Name
1 1 SI O Set ID - Patient ID
2 30 ST O Chart Number Patient ID (External ID)
3 30 CM R Account # Medical Record Number 1
4 N/A Alternate Patient ID – PID
5 PN R Patient Name
5.1 30 ST R Last Name Last Name
5.2 30 ST R First Name First Name
5.3 1 ST O M.I. Middle Initial
5.4 3 ST O Title Title
6 N/A Mother’s Maiden Name
7 8 DT R DOB Date/Time of Birth
8 1 ST R Sex (M,F or U) Sex
9 N/A Patient Alias
10 N/A Race
11 AD O Patient Address
11.1 50 ST O Address 1 Address Line 1
11.2 50 ST O Address 2 Address Line 2
11.3 20 ST O City City
11.4 2 ST O State State
11.5 10 ST O Zip Zip
12 N/A Country Code
13 10 TN O Home Tel Phone Number – Home 2
14 17 TN O Work Tel / Ext Phone Number – Business 3
15 N/A Primary Language
16 1 ST O Marital Status Marital Status
17 N/A Religion
18 ST O Hospital Case # Patient Account Number
19 9 ST R SSN SSN Number - Patient
1. The longest length of the medical record number field in SequelMed is 30
2. Format of the phone number is standard HL7 (|9999999999|)
3. Format of the phone number is standard HL7 (|999999-9999^99999|)

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 PV1 – Patient Visit Segment
The PV1 segment is used by the applications to communicate information on a visit-specific basis.

PV1 Segment

Sequence Length Type Required SequelMed HL7 Note

Number /Optional Field Name Field Name
1 SI O Set ID
2 N/A Patient Class
3 10 ST R Location Assigned Patient Location
4 N/A Admission Type
5 N/A Preadmit Number
6 N/A Prior Patient Location
7 R Provider Attending Provider Number
7.1 10 ST R Provider Short Name ID Number
7.2 20 ST Last Name Family Name
7.3 20 ST First Name Given Name
7.4 1 ST M.I Middle Initial
8 O Ref. Prov Referring Provider Number
8.1 10 ST Provider Short Name ID Number
8.2 20 ST Last Name Family Name
8.3 20 ST First Name Given Name
9 N/A Consulting Doctor
10 N/A Hospital Service
11 N/A Temporary Location
12 N/A Preadmit Test Indicator
13 N/A Readmission Indicator
14 N/A Admit Source
15 N/A Ambulatory Status
16 N/A VIP Indicator
17 N/A Admitting Doctor
18 N/A Patient Type
19 N/A Visit Number
20 N/A Financial Class
21 N/A Charge Price Indicator
22 N/A Courtesy Code
23 N/A Credit Rating
24 N/A Contract Code
25 N/A Contract Effective Date
26 N/A Contract Amount
27 N/A Contract Period
28 N/A Interest Code
29 N/A Transfer to Bad Debt Code
30 N/A Transfer to Bad Debt Date
31 N/A Bad Debt Agency Code
32 N/A Bad Debt Transfer Amount
33 N/A Bad Debt Recovery Amount
34 N/A Delete Account Indicator
35 N/A Delete Account Date
36 N/A Discharge Disposition
37 N/A Discharged to Location

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38 N/A Diet Type
39 N/A Servicing Facility
40 N/A Bed Status
41 N/A Account Status
42 N/A Pending Location
43 N/A Prior Temporary Location
44 DT O Admit Date Admit Date/Time
45 DT O Discharge Date Discharge Date/Time
46 N/A Current Patient Balance
47 N/A Total Charges
48 N/A Total Adjustments
49 N/A Total Payments
50 N/A Alternate Visit ID
51 N/A Visit Indicator
52 N/A Other Healthcare Provider

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 IN1 – Insurance Information Segment
The IN1 segment contains insurance policy coverage information necessary to produce properly
pro-rated patient and insurance bills.

IN1 Segment

Sequence Length Type Required SequelMed HL7 Note

Number /Optional Field Name Field Name
1 1 SI R Insurance Sequence 1
2 10 ST R Plan Short Name Insurance Plan ID
3 10 ST R Insurance Short Name Insurance Company ID
4 100 ST O Insurance Description Insurance Company Name
5 AD O Plan Address Insurance Company Address
5.1 50 ST Address Address Line 1
5.2 50 N/A Address Line 2
5.3 20 ST City City
5.4 2 ST State State
5.5 10 ST Zip Zip
6 30 ST O Plan Contact Insurance Co. Contact Person
7 17 TN O Plan Tel1/Ext Insurance Co Phone Number
8 30 ST O Group Group Number
9 N/A Group Name
10 N/A Insured’s Group Emp ID
11 N/A Insured’s Group Emp Name
12 N/A Plan Effective Date
13 8 DT O Plan Expiration Date Plan Expiration Date
14 N/A Authorization Information
15 N/A Plan Type
16 PN R Insured Party Name Name of Insured
16.1 30 ST Last Name Last Name
16.2 30 ST First Name First Name
17 1 ST R Rel (H, O, C, S) Insured’s Relationship to Patient 2
18 8 DT R DOB Insured’s Date Of Birth
19 AD R Insured Party Address Insured’s Address
19.1 50 ST Address1 Address Line 1
19.2 50 ST Address2 Address Line 2
19.3 20 ST City City
19.4 2 ST State State
19.5 10 ST Zip Zip
20 N/A Assignment Of Benefits
21 N/A Coordination Of Benefits
22 N/A Coord Of Ben. Priority
23 N/A Notice Of Admission Flag
24 N/A Notice Of Admission Date
25 N/A Report Of Eligibility Flag
26 N/A Report Of Eligibility Date
27 N/A Release Information Code
28 N/A Pre-Admit Cert (PAC)
29 N/A Verification Date/Time
30 N/A Verification By

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 31 N/A Type Of Agreement Code
32 N/A Billing Status
33 N/A Lifetime Reserve Days
34 N/A Delay Before L.R. Day
35 N/A Company Plan Code
36 30 ST R Plan ID Num Policy Number
37 30 NM O Visit Co Pay Policy Deductible
38 N/A Policy Limit - Amount
39 N/A Policy Limit - Days
40 N/A Room Rate - Semi-Private
41 N/A Room Rate - Private
42 N/A Insured’s Employment Status
43 1 ST R Sex (M, F, U) Insured’s Sex
44 O Insured’s Employer Address

1. For patient first insurance the insurance sequence must be 1. If patient has more than
one insurance then IN1 segment is repeated and the insurance sequence number
increases for each insurance.

2. H = Self , O = Other , C = Child , S = Spouse

IN2 – Insurance Additional Information Segment

The IN2 segment contains additional insurance policy coverage and benefit information necessary
for proper billing and reimbursement.

IN2 Segment

Sequence Length Type Required SequelMed HL7 Note

Number /Optional Field Name Field Name
1 N/A Insured’s Employee ID
2 10 ST O Insured’s SSN Insured’s Social Security Number
3 10 ST O Insured’s Employer Insured’s Employer Name
Name

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 ZLA – Lawyer Information Segment
The ZLA segment contains Insured’s Lawyer information.

ZLA Segment

Sequence Length Type Required SequelMed Note

Number /Optional Field Name
1 4 SI R Set ID 1
2 30 ST R Insured Lawyer’s Name
3 30 ST R Insured Lawyer’s Firm
4 30 ST O Contact Person
5 15 ST O License #
6 17 TN O Tel1 / Ext
7 10 TN O Tel2
8 AD O Lawyer’s Address
8.1 50 ST O Address Line 1
8.2 50 ST O Address Line 2
8.3 20 ST O City
8.4 2 ST O State
8.5 10 ST O Zip

1. As Lawyer information is related to insurance information. The Set ID should match IN1
segment (field Insurance Sequence).

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 GT1 – Guarantor Segment
The GT1 segment contains guarantor information (e.g., the person or the organization with financial
responsibility for payment of a patient account).

GT1 Segment

Sequence Length Type Required SequelMed HL7 Note

Number /Optional Field Name Field Name
1 N/A Set ID
2 N/A Guarantor Number
3 PN R Patient Responsible Party Guarantor Name
Name
3.1 30 ST R Last Name Last Name
3.2 30 ST R First Name First Name
3.3 1 ST O M.I Middle Initial
3.4 3 ST O Title Title
4 N/A Guarantor Spouse Name
5 AD O Guarantor Address
5.1 50 ST Address1 Address Line 1
5.2 50 ST Address2 Address Line 2
5.3 20 ST City City
5.4 2 ST State State
5.5 10 ST Zip Zip
6 10 TN O Home Tel Guarantor Ph Num-Home
7 17 TN O Tel/Ext Guarantor Ph Num-Business
8 8 DT O DOB Guarantor Date Of Birth
9 N/A Guarantor Sex
10 N/A Guarantor Type
11 1 ST O Relationship (C, F, L, O, S) Guarantor Relationship 1
12 9 ST O SSN Guarantor SSN
13 N/A Guarantor Date - Begin
14 N/A Guarantor Date - End
15 N/A Guarantor Priority
16 30 ST O Patient Responsible Party Guarantor Employer Name
Employer
17 O Patient Responsible Party Guarantor Employer
Employer Addr Address
17.1 50 ST N/A Address Line 1
17.2 50 ST N/A Address Line 2
17.3 20 ST N/A City
17.4 2 ST N/A State
17.5 10 ST N/A Zip
18 17 TN O Patient Responsible Party Guarantor Employer Phone
Employer Work Tel / Ext Number
49 30 ST O Job Title Job Title

1) C = Child , F = Friend , L = Lawyer , O = Other , S = Spouse

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 ZSC – School Information Segment
The ZSC segment contains Patient’s School information.

ZSC Segment

Sequence Length Type Required SequelMed Note

Number /Optional Field Name
1 30 ST R Patient’s School
2 17 TN O Tel1 / Ext
3 10 TN O Tel 2
4 10 TN O Fax
5 AD O School’s Address
5.1 50 ST O Address Line 1
5.2 50 ST O Address Line 2
5.3 20 ST O City
5.4 2 ST O State
5.5 10 ST O Zip

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 Sample Transaction

MSH|^~\&| |SEQUELMED|||200210081811|| DFT ^P01|0000001234|P|2.3|

PID|||PATID1234||ASHBY^PATRICK^A^Jr.||19650610|M|||1970 HEMPSTEAD TPKE^^EAST

MEADOW^NY^11554-3344||5162222240|5162222240^1447||M|||123456789|

PV1|||QUEENS||||JKIM^KIM^JOHN^B|SQAD^QADRI^SHAFIQ|

IN1|1|LIBERTY^OXFORD LIBERTY MUTUAL|OXFORD|OXFORD MUTUAL COMPANY|1970

HEMPSTEAD TPKE^^EAST MEADOW^NY^11554|MO^MOLLY|5162222222|DHS766||||
|20020101|||CORITSIDUS^GEORGE|H|19650201|340 DIXON ROAD^APT
1987^BRIARWOOD^NY^11340|||||||||||||||||1234567A|15.00||||||M||

ZLA|1CHUCK SPHAR|SPHAR LAW ASSOCIATE|PEGGY VOLPAGE|AS4542|5162222240|

5162222240|1970 HEMPSTEAD TPKE^^EAST MEADOW^NY^11554|

GT1|||KAUFMAN^MURRAY^A^Sr.||23 QUUENS STREET^^NEW BRUNSWICK^NJ^11554|

2012222240|5162222240|19651011|||L|123456789||||SEQUEL SYSTEMS|1970 HEMPSTEAD
TPKE^^EAST MEADOW^NY^11554|5162223333|||||||||||||||||||||||||||||||PROGRAMMER|

ZSC|QUEENS COLLEGE|7182222240|7182341240|7182549240|1970 QUEENS

ROAD^^FLUSHING^NY^11554-3344|

Note:
1. Every message starts with VT (Vertical Tab) ASCII character 0b or decimal character
11.
2. Every Segment ends with (Carriage Return) ASCII characters 0d decimal character 13.
3. Every message ends with FSCR (File Separator and Carriage Return) ASCII
characters 1cod decimal character 2813.

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 P03
The Detail Financial Transaction (DFT) message (P03 trigger event is use to add the patient
charges) is used to describe a financial transaction transmitted between systems, that is, to the
billing system.

PID – Patient Identification Segment

The PID segment is used by all applications as the primary means of communicating patient
identification information. This segment contains permanent patient identifying and demographic
information that, for the most part, is not likely to change frequently.

PID Segment

Sequence Length Type Required SequelMed HL7 Note

Number /Optional Field Name Field Name
1 1 SI O Set ID - Patient ID
2 30 ST O Chart Number Patient ID (External ID)
3 30 CM R Account # Medical Record Number 1
4 N/A Alternate Patient ID – PID
5 PN R Patient Name
5.1 30 ST R Last Name Last Name
5.2 30 ST R First Name First Name
5.3 1 ST O M.I. Middle Initial
5.4 3 ST O Title Title
6 N/A Mother’s Maiden Name
7 8 DT R DOB Date/Time of Birth
8 1 ST R Sex (M,F or U) Sex
9 N/A Patient Alias
10 N/A Race
11 AD O Patient Address
11.1 50 ST O Address 1 Address Line 1
11.2 50 ST O Address 2 Address Line 2
11.3 20 ST O City City
11.4 2 ST O State State
11.5 10 ST O Zip Zip
12 N/A Country Code
13 10 TN O Home Tel Phone Number – Home 2
14 17 TN O Work Tel / Ext Phone Number – Business 3
15 N/A Primary Language
16 1 ST O Marital Status Marital Status
17 N/A Religion
18 ST O Hospital Case # Patient Account Number
19 9 ST R SSN SSN Number - Patient

1. The longest length of the medical record number field in SequelMed is 30

2. Format of the phone number is standard HL7 (|9999999999|)
3. Format of the phone number is standard HL7 (|999999-9999^99999|)

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 PV1 – Patient Visit Segment
The PV1 segment is used by the applications to communicate information on a visit-specific basis.

PV1 Segment

Sequence Length Type Required SequelMed HL7 Note

Number /Optional Field Name Field Name
1 SI O Set ID
2 N/A Patient Class
3 10 ST R Location Assigned Patient Location
4 N/A Admission Type
5 N/A Preadmit Number
6 N/A Prior Patient Location
7 R Provider Attending Provider Number
7.1 10 ST R Provider Short Name ID Number
7.2 20 ST Last Name Family Name
7.3 20 ST First Name Given Name
7.4 1 ST M.I Middle Initial
8 O Ref. Prov Referring Provider Number
8.1 10 ST Provider Short Name ID Number
8.2 20 ST Last Name Family Name
8.3 20 ST First Name Given Name
9 N/A Consulting Doctor
10 N/A Hospital Service
11 N/A Temporary Location
12 N/A Preadmit Test Indicator
13 N/A Readmission Indicator
14 N/A Admit Source
15 N/A Ambulatory Status
16 N/A VIP Indicator
17 N/A Admitting Doctor
18 N/A Patient Type
19 N/A Visit Number
20 N/A Financial Class
21 N/A Charge Price Indicator
22 N/A Courtesy Code
23 N/A Credit Rating
24 N/A Contract Code
25 N/A Contract Effective Date
26 N/A Contract Amount
27 N/A Contract Period
28 N/A Interest Code
29 N/A Transfer to Bad Debt Code
30 N/A Transfer to Bad Debt Date
31 N/A Bad Debt Agency Code
32 N/A Bad Debt Transfer Amount
33 N/A Bad Debt Recovery Amount
34 N/A Delete Account Indicator
35 N/A Delete Account Date
36 N/A Discharge Disposition
37 N/A Discharged to Location

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 38 N/A Diet Type
39 N/A Servicing Facility
40 N/A Bed Status
41 N/A Account Status
42 N/A Pending Location
43 N/A Prior Temporary Location
44 DT O Admit Date Admit Date/Time
45 DT O Discharge Date Discharge Date/Time
46 N/A Current Patient Balance
47 N/A Total Charges
48 N/A Total Adjustments
49 N/A Total Payments
50 N/A Alternate Visit ID
51 N/A Visit Indicator
52 N/A Other Healthcare Provider

DB1 - Disability segment

The disability segment contains information related to the disability of a person.

DB1 Segment

Sequence Length Type Required SequelMed HL7 Note

Number /Optional Field Name Field Name
1 N/A Set ID - DB1
2 N/A Disabled person code
3 N/A Disabled person identifier
4 N/A Disabled Indicator
5 N/A Disability start date
6 N/A Disability end date
7 8 DT O Unable to work to Date Disability return to work date
8 8 DT O Unable to work from date Disability unable to work date

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 FT1 - financial transaction segment

The FT1 segment contains the detail data necessary to post charges patient accounting records.

FT1 Segment

Sequence Length Type Required SequelMed HL7 Note

Number /Optional Field Name Field Name
1 1 Set ID -FT1 1
2 N/A Transaction ID
3 36 ST O Transaction Batch ID
4 8 DT O Transaction Date
5 N/A Transaction Posting Date
6 2 ST R Value CG (Charge) Transaction Type
7 N/A Transaction Code
8 N/A Transaction Description
9 N/A Transaction Description – Alt
10 4 NM Units Transaction Quantity
11 N/A Transaction Amount – Extended
12 N/A Transaction Amount – Unit
13 N/A Department Code
14 10 ST Visit Plan Insurance Plan ID
15 18 NM Plan Amt Insurance Amount
16 10 ST Location Assigned Patient Location
17 18 NM Fee Fee Schedule
18 N/A Patient Type
19 10 ST R Visit Diagnosis Diagnosis Code 2
20 N/A Performed By Code
21 N/A Ordered By Code
22 N/A Unit Cost
23 N/A Filler Order Number
24 N/A Entered By Code
25 10 ST R Visit Procedure Procedure Code

1) This field contains the number that identifies this transaction. For the first occurrence of
Segment sequence number shall be 1, for the second occurrence it shall be 2, etc.

2) Diagnosis code can be repeated up to four.

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 ACC - accident segment

The ACC segment contains patient information relative to an accident in which the patient has been
involved.

ACC Segment

Sequence Length Type Required SequelMed HL7 Note

Number /Optional Field Name Field Name
1 8 DT O Injury/Accident Date Accident Date/Time
2 N/A Accident Code
3 N/A Accident Location
4 2 ST O Accident State Auto Accident State
5 1 ST O Job Related (Y/N) Accident Job Related Indicator
6 N/A Accident Death Indicator

Sample Transaction

MSH|^~\&| |SEQUELMED|||200210081811||DFT^P03|0000001234|P|2.3|

PID|||PATID1234||ASHBY^PATRICK^A^Jr.||19650610|M|||1970 HEMPSTEAD TPKE^^EAST

MEADOW^NY^11554-3344||5162222240|5162222240^3217||M|||123456789|

PV1|||QUEENS||||JKIM^KIM^JOHN^B|SQAD^QADRI^SHAFIQ||||||||||||||||||||||||||||||||||||20021010|20021
010|

DB1|||||||20021008|20021012|

FT1|1|||20021012||CG||||2||||LIBERTY|200|QUEENS|200||784.0^ HEADACHE~924.3^ SUBUNGUAL

HETATOMA||||||2011^ INJECTION|

ACC|20021008|||NY|Y||

Note:

1. Every message starts with VT (Vertical Tab) ASCII character 0b or decimal character 11.
2. Every Segment ends with (Carriage Return) ASCII characters 0d decimal character 13.
3. Every message ends with FSCR (File Separator and Carriage Return) ASCII characters
1cod decimal character 2813.

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