export_encounter
export_encounter
All data related to a single encounter. Payer Plan Group refers to Payer Plans.
Primary Key: encounter_id, claim_id
Identifiers
Unique ID associated with the encounter in the Candid system
Encounter External ID (originating from the EMR / EHR)
Patient External ID
Guarantor external ID
Primary subscriber / policyholder member ID
Secondary subscriber / policyholder member ID
Tertiary subscriber / policyholder member ID
Unique Claim ID
Timestamps
Time at which the encounter is first created in the database
Time at which the encounter is updated in the database (note: the database tables overall are updated at 5 AM EST daily)
When was the encounter soft-deleted from the Candid system?
Organization
User’s unique organization ID in the Candid system
User’s Organization / Company Name
Organization’s External ID - the ID that the organization uses to map to their own upstream system
Patient Information
Does the patient have an authorized release claim?
Patient First Name
Patient Last Name
Patient Gender
Patient Date of Birth
Patient Address (first line)
Patient Address (second line / additional info)
Patient Address City
Patient Address State
Patient Address Zip Code
Patient Address Zip Code (plus four code)
Patient phone number
Patient provided consent by phone?
Patient email
Patient provided consent by email?
Patient Reason for Visit Code (Institutional Claims only)
Billing Provider
Billing Provider ID
Billing Provider First Name
Billing Provider Last Name
Billing Provider Organization Name
Billing Provider Tax ID
Billing Provider NPI
Billing Provider Taxonomy Code
Specific code used on claim forms to identify the billing provider
Billing Provider Address Line
Billing Provider Additional Address Line
Billing Provider City
Billing Provider State
Billing Provider Zip Code
Billing Provider Zip Code (Additional Numbers)
Rendering Provider
Rendering Provider First Name
Rendering Provider Last Name
Rendering Provider Organization Name
Rendering Provider Tax ID
Rendering Provider NPI Number
Rendering Provider Taxonomy Code
Specific code used on claim forms to identify the rendering provider
Rendering provider address
Rendering provider address (second line / additional info)
Rendering provider address city
Rendering provider address state
Rendering provider address zip code
Rendering provider address zip code (plus four code)
Treating Provider ID
Treating Provider First Name
Treating Provider Last Name
Treating Provider Tax ID
Treating Provider NPI Number
Treating Provider Taxonomy Code
Treating Provider License Type
Treating Provider Main Address
Treating Provider Secondary Address Field
Treating Provider City
Treating Provider State
Treating Provider Zip Code
Treating Provider Zip Code (Plus Four code)
Referring Provider
Referring Provider First Name
Referring Provider Last Name
Referring Provider Organization Name
Referring Provider Tax ID
Referring Provider NPI Number
Referring Provider Taxonomy Code
Referring Provider Qualifier
Referring Provider Address
Referring Provider Address (Additional Information)
Referring Provider City
Referring Provider State
Referring Provider Zip Code
Referring Provider Zip Code (Plus Four Code)
Initial Referring Provider First Name
Initial Referring Provider Last Name
Initial Referring Provider Organization
Initial Referring Provider Tax ID
Initial Referring Provider NPI
Initial Referring Provider Taxonomy Code
Specific code used on claim forms to identify the initial referring provider
Initial Referring Provider Address Line
Initial Referring Provider Address (Second Line)
Initial Referring Provider City
Initial Referring Provider State
Initial Referring Provider Zip Code
Initial Referring Provider Zip Code (Plus Four Code)
Attending Provider
Attending Provider First Name (Institutional Claims only)
Attending Provider Last Name (Institutional Claims only)
Attending Provider Organization Name (Institutional Claims only)
Attending Provider Tax ID (Institutional Claims only)
Attending Provider NPI (Institutional Claims only)
Attending Provider Taxonomy Code (Institutional Claims only)
Attending Provider Qualifier (Institutional Claims only)
Attending Provider Address (Institutional Claims only)
Attending Provider Address (additional information) (Institutional Claims only)
Attending Provider Address City (Institutional Claims only)
Attending Provider Address State (Institutional Claims only)
Attending Provider Address Zip Code (Institutional Claims only)
Attending Provider Address Zip Code (Institutional Claims only)
Supervising Provider
Supervising Provider First Name
Supervising Provider Last Name
Supervising Provider Organization Name
Supervising Provider Tax ID
Supervising Provider NPI
Supervising Provider Taxonomy Code
Specific code used on a claim form to identify the healthcare professional who was responsible for overseeing the services rendered to a patient
Supervising Provider Address Line
Supervising Provider Second Address
Supervising Provider City
Supervising Provider State
Supervising Provider Zip Code
Supervising Provider Zip Code (Additional Numbers)
Ordering Provider
Ordering Provider’s First Name
Ordering Provider’s Last Name
Ordering Provider’s Organization Name
Ordering Provider’s Tax ID
Ordering Provider’s NPI number
Ordering Provider’s Taxonomy Code
Specific code used in medical billing to identify the healthcare professional who ordered a particular service or item for a patient
Ordering Provider’s Address Line 1
Ordering Provider’s Address Line 2
Ordering Provider’s City
Ordering Provider’s State
Ordering Provider’s Zip Code
Ordering Provider’s Zip Code (Additional Numbers)
Service Facility
Service Facility ID
Service Facility Organization Name
Service Facility NPI
Service Facility Address (first line)
Service Facility Address (second line / additional information)
Service Facility Address City
Service Facility Address State
Service Facility Address Zip Code
Service Facility address Zip Code (plus 4 code digits)
Subscriber - Primary
Primary subscriber / policyholder first name
Primary subscriber / policyholder last name
Primary subscriber / policyholder gender
Primary subscriber / policyholder date of birth
Primary subscriber / policyholder relationship to patient
Primary subscriber / policyholder address
Primary subscriber / policyholder address (second line / additional information)
Primary subscriber / policyholder city
Primary subscriber / policyholder state
Primary subscriber / policyholder zip code
Primary subscriber / policyholder zip code (plus four code)
Primary subscriber / policyholder group number
Unique identifier for the primary subscriber / policyholder payer plan
Specific name for the primary subscriber / policyholder payer plan
Primary subscriber / policyholder insurance card plan name
Primary subscriber / policyholder insurance card plan type
Primary subscriber / policyholder insurance type
Primary subscriber / policyholder payer name
Primary subscriber / policyholder payer ID
Primary subscriber / policyholder prescription Bank Identification Number - a six-digit number found on your health insurance card that is used to process prescription drug claims
Primary subscriber / policyholder Processor Control Number
Primary subscriber / policyholder payer address
Primary subscriber / policyholder payer address (second line / additional information)
Primary subscriber / policyholder payer city
Primary subscriber / policyholder payer state
Primary subscriber / policyholder payer zip code
Primary subscriber / policyholder payer zip code (plus four code)
Subscriber - Secondary
Secondary subscriber / policyholder first name
Secondary subscriber / policyholder last name
Secondary subscriber / policyholder gender
Secondary subscriber / policyholder date of birth
Secondary subscriber / policyholder relationship to patient
Secondary subscriber / policyholder address
Secondary subscriber / policyholder address (second line / additional information)
Secondary subscriber / policyholder city
Secondary subscriber / policyholder state
Secondary subscriber / policyholder zip code
Secondary subscriber / policyholder zip code (plus four code)
Secondary subscriber / policyholder group number
Unique identifier for the specific plan associated with the subscriber / policyholder’s secondary payer
Name of the specific plan associated with the secondary subscriber / policyholder
Secondary subscriber / policyholder insurance card plan name
Secondary subscriber / policyholder insurance card plan type
Secondary subscriber / policyholder insurance type
Secondary subscriber / policyholder payer name
Secondary subscriber / policyholder payer ID
Secondary subscriber / policyholder prescription Bank Identification Number - a six-digit number found on your health insurance card that is used to process prescription drug claims
Secondary subscriber / policyholder Processor Control Number
Secondary subscriber / policyholder payer address
Secondary subscriber / policyholder payer address (second line / additional information)
Secondary subscriber / policyholder payer city
Secondary subscriber / policyholder payer state
Secondary subscriber / policyholder payer zip code
Secondary subscriber / policyholder payer zip code (plus four code)
Subscriber - Tertiary
Tertiary subscriber / policyholder first name
Tertiary subscriber / policyholder last name
Tertiary subscriber / policyholder gender
Tertiary subscriber / policyholder date of birth
Tertiary subscriber / policyholder relationship to patient
Tertiary subscriber / policyholder address
Tertiary subscriber / policyholder address (second line / additional information)
Tertiary subscriber / policyholder city
Tertiary subscriber / policyholder state
Tertiary subscriber / policyholder zip code
Tertiary subscriber / policyholder zip code (plus four code)
Tertiary subscriber / policyholder group number
Unique identifier for the specific plan associated with the subscriber / policyholder’s tertiary payer
Name of the specific plan associated with the tertiary subscriber / policyholder
Tertiary subscriber / policyholder insurance card plan name
Tertiary subscriber / policyholder insurance card plan type
Tertiary subscriber / policyholder insurance type
Tertiary subscriber / policyholder payer name
Tertiary subscriber / policyholder payer ID
Tertiary subscriber / policyholder prescription Bank Identification Number - a six-digit number found on your health insurance card that is used to process prescription drug claims
Tertiary subscriber / policyholder Processor Control Number
Tertiary subscriber / policyholder payer address
Tertiary subscriber / policyholder payer address (second line / additional information)
Tertiary subscriber / policyholder payer city
Tertiary subscriber / policyholder payer state
Tertiary subscriber / policyholder payer zip code
Tertiary subscriber / policyholder payer zip code (plus four code)
Guarantor
Guarantor first name
Guarantor last name
Guarantor Date of Birth
Guarantor Address
Guarantor Address (second line / additional info)
Guarantor address city
Guarantor address state
Guarantor address zip code
Guarantor address zip code (plus four code)
Guarantor phone number
Guarantor provided consent by phone?
Guarantor email
Guarantor provided consent by email?
Claim Information
Claim Form Type (professional or institutional)
Claim Patient Control Number
Claim Externally Generated Patient Control Number
Claim Status
Claim Adjudicated Network Status
Claim CLIA Number
External Cause of Injury Code (Institutional Claims only)
Condition codes (Institutional Claims only)
Diagnosis
Diagnosis Codes
Diagnosis related group code (Institutional Claims only)
Other
Encounter Date of Service
Prior Authorization Number / unique code from payer confirming a procedure or service is approved
Does provider have an authorized assignment of benefits form? (Are patients’ payers authorized to directly pay the provider for the services rendered?)
Did the provider accept assignment?
Notes on the Appointment Type (follow-up, initial assessment, etc.)
Two-digit code indicating the setting where healthcare services were provided and / or rendered
Place of Service Code as it is submitted to the Payer (after it has been run through the Rules Engine / POS configurations)
Standard codes to communicate why a claim’s processing or payment has been delayed
Assignment of a patient to a specific healthcare provider or group
Synchronous vs. Asynchronous
A four-digit code that identifies the facility type, bill classification, and sequence of the bill (Institutional Claims only)
Admission Source code that identifies where a patient originated before admission, essential for inpatient/outpatient institutional claims (Institutional Claims only)
One-digit code indicating the priority of an inpatient admission (Institutional Claims only)
Admission Date (Institutional Claims only)
Admission Hour (Institutional Claims only)
Two-digit codes indicating a patient’s destination or status upon leaving a facility (Institutional Claims only)
Discharge Date (Institutional Claims only)
Discharge Hour (Institutional Claims only)
Two-letter accident state abbreviation (or province code) (Institutional Claims only)
Pay to address
Pay to address (additional info)
Pay to address city
Pay to address state
Pay to address zip code
Pay to address zip code (plus four code)
Height in inches
Weight in Lbs
Systolic Blood Pressure (mmHg)
Diastolic Blood Pressure (mmHg)
Body Temperature
Hemoglobin (grams / deciliter)
Hematocrit Value / Percentage
Billing type (Self Pay vs Insurance Pay)
Responsible Party on a Claim (Payer, Patient, Non-Insurance, None)
Billable vs. Not Billable
The ICD-10-CM code provided by a physician at the time of patient admission (Institutional Claims only)
Two-digit codes to report financial or numerical data related to specific conditions, such as Medicare deductibles, no-fault payments, oxygen saturation levels, or insurance coordination (Institutional Claims only)” }
Custom Metadata / KVPs - custom metadata created by the Customer
Tags
Date First Submitted
Date Last Submitted
Has the encounter been soft deleted from the Candid system?