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| Column Name | Description | Data Populates From |
|---|---|---|
| Agency | Collection Agency | Patient Chart |
| Encounter | Source Number | Encounter Maintenance |
| Enc Dt | Encounter Billable Date | Encounter Maintenance |
| Pat Rsp Dt | Patient Responsibility Date | Encounter Maintenance |
| Pre Eff Dt | Pre List Effective Date | Bad Debt Process |
| Amt Due | Amount Due | Transaction Detail |
| UnPosted Amt | Unposted Amount | Transaction Detail |
| Pat Name | Patient Name | Patient Information |
| Debt Sts | Debt Status | |
| Pat Addr 1 | Patient Address 1 | Patient Information |
| Pat City, State Zip | City, State Zip | Patient Information |
| Pat Country | Country | Patient Information |
| Pat County | County | Patient Information |
| Pat SSN | Patient Social Security Number | Patient Information |
| Pat Phone | Patient Home Phone | Patient Information |
| Pat Day Phone | Patient Day Phone | Patient Information |
| Sex | Sex Description | Patient Information |
| Pat Birth Dt | Patient Birth Date | Patient Information |
| Pat Age | Patient Age | Patient Information |
| Pat Age in Years | Patient Age in Years | Patient Information |
| Pat Age in Months | Patient Age in Months | Patient Information |
| Pat Age in Years (DOS) | Patient Age in Years on the Date of Service | Patient Information |
| Pat Age in Months (DOS) | Patient Age in Months on the Date of Service | Patient Information |
| Pat Email Addr | Patient Email Address | Patient Information |
| Client Def 1 - 14 | Enterprise Client Defined 1 - 14 Fields
| |
| Guar Name | Guarantor Name | Guarantor Information |
| Guar Addr 1 | Guarantor Address 1 | Guarantor Information |
| Guar City, State Zip | Guarantor City, State Zip | Guarantor Information |
| Guar Country | Guarantor Country | Guarantor Information |
| Guar County | Guarantor County | Guarantor Information |
| Guar SSN | Guarantor Social Security Number | Guarantor Information |
| Guar Phone | Guarantor Home Phone | Guarantor Information |
| Guar Day Phone | Guarantor Day Phone | Guarantor Information |
| Guar Email Addr | Guarantor Email Address | Guarantor Information |
| Emp Name | Employer Name | |
| Emp Addr 1 | Employer Address 1 | |
| Emp City | Employer City | |
| Emp State | Employer State | |
| Emp Zip | Employer Zip | |
| Emp Phone | Employer Phone | |
| Emp Fax | Employer Fax | |
| Emp Cont | Employer Contact | |
| Emp Ext | Employer Contact Phone Extension | |
| Prim Payer | Primary Payer | Encounter Insurance Information |
| Prim Payer Addr 1 | Primary Payer Address 1 | Encounter Insurance Information |
| Prim Payer City | Primary Payer City | Encounter Insurance Information |
| Prim Payer State | Primary Payer State | Encounter Insurance Information |
| Prim Payer Zip | Primary Payer Zip | Encounter Insurance Information |
| Prim Payer Cont | Primary Payer Contact | Encounter Insurance Information |
| Prim Payer Cont Phone | Primary Payer Contact Phone | Encounter Insurance Information |
| Prim Payer Fax | Primary Payer Fax | Encounter Insurance Information |
| Sec Payer | Secondary Payer | Encounter Insurance Information |
| Sec Payer Addr 1 | Secondary Payer Address 1 | Encounter Insurance Information |
| Sec Payer City | Secondary Payer City | Encounter Insurance Information |
| Sec Payer State | Secondary Payer State | Encounter Insurance Information |
| Sec Payer Zip | Secondary Payer Zip | Encounter Insurance Information |
| Sec Payer Cont | Secondary Payer Contact | Encounter Insurance Information |
| Sec Payer Cont Phone | Secondary Payer Contact Phone | Encounter Insurance Information |
| Sec Payer Fax | Secondary Payer Fax | Encounter Insurance Information |
| Tert Payer | Tertiary Payer | Encounter Insurance Information |
| Tert Payer Addr 1 | Tertiary Payer Address 1 | Encounter Insurance Information |
| Tert Payer City | Tertiary Payer City | Encounter Insurance Information |
| Tert Payer State | Tertiary Payer State | Encounter Insurance Information |
| Tert Payer Zip | Tertiary Payer Zip | Encounter Insurance Information |
| Tert Payer Cont | Tertiary Payer Contact | Encounter Insurance Information |
| Tert Payer Cont Phone | Tertiary Payer Contact Phone | Encounter Insurance Information |
| Tert Payer Fax | Tertiary Payer Fax | Encounter Insurance Information |
| Last Pat Pay Date | Last Patient Pymt Date from Acct | Guarantor's Account Profile |
| Last Pat Pay Amt | Last Patient Pymt Amt from Acct | Guarantor's Account Profile |
| Homeless Status | Homeless Status | |
| Migrant Worker | Migrant Worker Status | |
| Language Barrier | Language Barrier | |
| Primary Medical | Primary Medical Coverage | |
| Race | Race | Patient Information |
| Ethnicity | Ethnicity | Patient Information |
| Tribal Affiliation | Tribal Affiliation | |
| Blood Quantum | Blood Quantum | |
| School Based Hlth Care | School Based Health Care | |
| Public Housing Primary | Public Housing Primary Care | |
| Veteran Status | Veteran Status | Patient Information |
| Descendancy | Descendancy | |
| IHS Eligibility Status | IHS Eligibility Status | |
| Classification/Beneficiary | Classification/Beneficiary | |
| Community Code | Community Code | Patient Information |
| Consent To Treat Ind | Consent To Treat Indicator | |
| Consent To Treat Date | Consent To Treat Date | |
| Enc Homeless Status | Encounter Homeless Status | Encounter Maintenance |
| Prim Dental Prov Name | Primary Dental Provider Name | Patient Information |
| Race Category | Race Category | Race Category Mapping Master File
|
| Ethnicity Category | Ethnicity Category | Ethnicity Category Mapping Master File
|