HL7 Messages Standard Definition
Applicable to:
Capitation Based Funding
Electronic Registers
Version 3.11 Version Control
Date / Version / Description / Author22 Jul 2001 / Draft / First draft - High Level / Stu McKinlay
23 Aug 2001 / 2.00 / Add Trial Run Flag / Sheryll Mallett
27 Aug 2001 / 2.10 / Updated Post team review / Terry Corkery
04 Oct 2001 / 2.20 / Updated address field sizes as per Critchlow’s request / Sheryll Mallett
31 Oct 2001 / 2.30 / Cosmetic changes adding shading to fields not used or sent.
Removed date of enrolment confirmation field, as this should appear in the date of enrolment field.
Changed the Practice details contract number to Practice Id. Type of register changed from “PF” to “CF”.
Changed length of Provider type from 1 to 3. / Sheryll Mallett
6 Nov 2001 / 2.40 / Updated tables 4 and 5 for return of patient error records as per discussion with Colin. / Sheryll Mallett
19 Nov 2001 / 2.50 / Updated sample HL7 layout / Sheryll Mallett
27 Nov 2001 / 2.60 / Updated doc to add criteria around file naming / Sheryll Mallett
15 Mar 2002 / 2.70 / Reviewed document wording and segment definitions.
Changed message naming conventions so that invalidly formatted messages could receive error messages in standard format.
Renamed ZCT segment as ‘Claim Type’ (as per existing HB HL7 Messages).
Added sample formats to appendicies. / Stu McKinlay
20 Mar 2002 / 2.71 / Changed 'PCO' to a more generic 'Organisation' where applicable in order to cater for inclusion of PHO's and other organisations in the future.
Changed mandatory fields in line with business rules documentation.
03 Apr 2002 / 2.72 / Reviewed in accordance with the return of validation results to submitting organisation.
11 Jul 2002 / 3.0 / New Version for CBF Production Release. Includes the following :
1. Organisation Name and Logo changes
2. The term Capitated replaced by Capitation
3. The term Provider replaced by Practitioner
4. Updated Fig 1 re: Organisation replacing PCO/PHO, CIC support and Health Benefits becoming Health PAC
The above are not tracked.
5. Note on applicability of this spec to Capitation Information Cleansing ( CIC ). Also inserted a note that Payment Period is optional for CIC.
6. Modified 4.3.1 for : Practice must be followed by at least one Patient; Provider is optional, but when provided must be followed by at least one Patient.
7. Inserted section 4.3.2 regarding reserved and prohibited characters and unavailability of support for escape sequences. Also added a note to the same effect in 8.3.2.
8. Inserted a note in 5.2.5.3 on Rapid Addressing Numbers, and added an example in Appendix B
9. Added 8.3.8 MSH-8 Security which was missing.
10. Added file naming conventions for CBF and CIC to section 8.3.10 and updated 3.2 to refer to 8.3.10.
11. Added DOD field to 9.2 and two non-used missing fields from Patient Identification segment. Added 9.3.28 to 9.3.30 as Field Notes.
12. Changed 9.3.22 - PID-22 Ethnic Group from a compound to a repeating field.
13. In 14.2, changed Date of Last Consultation to Optional
14. Other minor corrections ( e.g. numbered PID-23 to PID-27 correctly
15. Added a note on the fields to be filled for point-of-contact geocoding to be considered complete.
16. Added DHB field to ZRD segment and added Field Notes.
17. Replaced Appendix C – Sample HL7 formats with corrections as provided by Leonie. / Subhasish Dutta
29 Jul 2002 / 3.01 / Merged the “Message Acknowledgements: Detailed Use Case Specification” into this document, as follows :
1. Added Acknowledgement Types as 3.2
2. Reorganised 4.3 Triggers – to emphasize Message Structure in 4.4 and Acknowledgement Structure in 4.5.
3. Added Acknowledgement Segments as section 16.
4. Added List of Errors as Appendix D.
5. Other minor reorganisations ( such as : removal of blank pages )
6. Note on optionality of patient address components.
7. Added examples for the File names of different acknowledgement types. / Subhasish Dutta
1 Aug 2002 / 3.02 / 1. Accepted all non-content related changes in the document, for onward transmission to PMS vendors.
2. Updated contact details to use HealthPAC Contact Centre after 20th August, and Donna Harrison prior to 20th August. / Subhasish Dutta
12 Aug 2002 / 3.03 / Updates made to Acknowledgement Messages :
1. ZER and ZSA custom CBF segment types added.
2. BNF Structure expanded
3. Registers and Acknowledgement Message Processing explained.
4. List of Error Identifiers corrected
5. Additional Sample files added.
6. Removed chapter 18 on Acknowledgement Types and Segments as this is covered elsewhere. / Subhasish Dutta
23 Sep2002 / 3.04 / Additions / Changes for Production release 2 as follows:
1. Additional Error Descriptions for :
· Valid Payment Reference Data for Organisation not found ( Error Id – 1003 )
· Practice Exception for Organisation absent in Register ( Error Id – 1005 )
2. Additional ZSA eror identifier of 3004 - Rejection of Patient due to death in previous quarter
3. Note on the mandatory/optionality of delimiters
4. Minor corrections / Subhasish Dutta
12 Mar 2004 / 3.05 / All “.reg” references changed to “.asr” Scheduled for PHO Release 5 as per DAA20 / Ronil Bhindi
26 Mar 2004 / 3.06 / · Change related to DAA20. Section 3.3.1 File Extension changed from “reg” to .asr”.
· Section 8.3.10 defines MSH-10-Message Control ID. The following examples in the appendices have been updated to be "CBFHL7OUT”:
· C.2.1, C2.2 changed to reflect Section 8.3.10
· Example 2, 3 and 4
· Change to CIC component of Section 8.3.10 to have the same structure for Message Control IDs for CBF files
· Reviewed by Subhasish Dutta / Ronil Bhindi
26 March 2004 / 3.07 / · Update to include the following three fields in the ZRD patient register segment as per DAA24 - Care Plus Initiative requirements:
· Enrolment Status
· Start date of enrolment
· End date of enrolment / Ronil Bhindi
27 April 2004 / 3.08 / Update to include Care Plus Initiative Requirements. / Lynda Kamstra
16 June 2004 / 3.09 / Update the version number as requested by Primary Care Working Group / Lynda Kamstra
7 November 2005 / 3.10 / Changed length of HUHC number from 6 to 7 / Philippa Burcher
2 May 2007 / 3.11 / Update to 15.3.20 ZRD-20-Care Plus Enrolment Start Date (remove rule that it must be on or after the ZRD-7-Date of Enrolment field) / Shane Kerr
Table of Contents
Version Control ii
Table of Contents vi
1. Brief Description 1
1.1 Introduction 1
1.1.1 Capitation Information Cleansing – Applicability of this specification 1
1.1.2 Point-of-contact geocoding 1
1.2 Scope 1
1.3 Background 2
1.4 HL7 Standards 2
2. GMS and Practice Nurse Capitation Based Funding 3
2.1 CBF Messaging 3
2.2 Assumptions 3
3. Transaction Definitions 5
3.1 Introduction 5
3.2 Acknowledgement Types 5
3.2.1 Accept Acknowledgements 5
3.2.2 Reject Acknowledgements 5
3.2.3 Error Acknowledgements 5
3.2.4 Validation Acknowledgements 6
3.3 File Naming Conventions 6
3.3.1 Registers Submitted to HealthPAC 6
3.3.2 Acknowledgement Files returned from HealthPAC 6
3.4 Transaction, Messages and Segments used 6
3.4.1 Transaction Summary 6
3.4.2 Message Type Summary 7
3.4.3 HL7 Segments Used 7
3.4.4 Column Headings 7
4. Capitation Based Funding Patient Registers 8
4.1 Function 8
4.2 Abstract Message Pair 8
4.3 Triggers 8
4.4 Structure of Patient Register 8
4.5 Structure of Patient Register Acknowledgement 9
4.6 Reserved Characters 11
4.7 Delimiters 11
5. Segment Definitions 13
5.1 Introduction 13
5.2 Segment Descriptions 13
5.2.1 Function 13
5.2.2 Table of Fields 13
5.2.3 Table of Field Usage 14
5.2.4 Field Notes 14
5.2.5 Data element type descriptions 14
6. Segment Descriptions 17
7. MSA - Message Acknowledgement Segment 18
7.1 Function 18
7.2 Table of Fields - MSA Segment 18
7.3 Field Notes 18
7.3.1 MSA-1-Acknowledgment Code 18
7.3.2 MSA-2-Message Control ID 18
7.3.3 MSA-3-Text Message 18
7.3.4 MSA-4-Expected Sequence Number 18
7.3.5 MSA-5-Delayed Acknowledgement Type 18
7.3.6 MSA-6-Error Condition 19
8. MSH - Message Header 20
8.1 Function 20
8.2 Table of Fields 20
8.3 Field Notes 20
8.3.1 MSH-1-Field separator 20
8.3.2 MSH-2-Encoding characters 20
8.3.3 MSH-3-Sending Application 21
8.3.4 MSH-4-Sending Facility 21
8.3.5 MSH-5-Receiving Application 21
8.3.6 MSH-6-Receiving Facility 21
8.3.7 MSH-7-Date/Time of Message 21
8.3.8 MSH-8-Security 21
8.3.9 MSH-9-Message Type 21
8.3.10 MSH-10-Message Control ID 21
8.3.11 MSH-11-Processing ID 22
8.3.12 MSH-12-Version ID 23
9. PID - Patient Identification 24
9.1 Function 24
9.2 Table of Fields - PID Segment 24
9.3 Field Notes 24
9.3.1 PID-1-Set Id 24
9.3.2 PID-2-Patient Id (External Id) 24
9.3.3 PID-3-Patient Id (Internal Id) 25
9.3.4 PID-4-Alternate Patient Id (Internal Id) 25
9.3.5 PID-5-Patient Name 25
9.3.6 PID-6-Mothers Maiden Name 25
9.3.7 PID-7-Date of Birth 25
9.3.8 PID-8-Gender 25
9.3.9 PID-9-Patient Alias 25
9.3.10 PID-10-Race 25
9.3.11 PID-11-Patient Address 25
9.3.12 PID-12-Country code 26
9.3.13 PID-13-Phone Number - Home 26
9.3.14 PID-14-Phone Number - Business 26
9.3.15 PID-15-Primary Language 26
9.3.16 PID-16-Marital Status 26
9.3.17 PID-17-Religion 26
9.3.18 PID-18-Patient Account Number 26
9.3.19 PID-19-SSN Number 26
9.3.20 PID-20-Drivers Licence Number 26
9.3.21 PID-21-Mother’s Identifier 26
9.3.22 PID-22-Ethnic Group 26
9.3.23 PID-23-Birth Place 27
9.3.24 PID-24-Multiple Birth Indicator 27
9.3.25 PID-25-Birth Order 27
9.3.26 PID-26-Citizenship 27
9.3.27 PID-27-Veterans Military Status 27
9.3.28 PID-28-Nationality 27
9.3.29 PID-29-Patient Death Date and Time 27
9.3.30 PID-30-Patient Death Indicator 28
10. PRD - Practitioner 29
10.1 Function 29
10.2 Table of Fields - PRD Segment 29
10.3 Field Notes 29
10.3.1 PRD-1-Practitioner Type 29
10.3.2 PRD-2-Practitioner Name 29
10.3.3 PRD-3-Practitioner Address 29
10.3.4 PRD-4-Practitioner Location 29
10.3.5 PRD-5-Practitioner Phone Number 29
10.3.6 PRD-6-Electronic Address 29
10.3.7 PRD-7-Preferred Method of Contact 29
10.3.8 PRD-8-Practitioner Identifiers 30
10.3.9 PRD-9-Effective Start Date of Role 30
10.3.10 PRD-10-Effective end Date of Role 30
11. ZCT –Claim Type 31
11.1 Function 31
11.2 Table of Fields 31
11.3 Field Notes 31
11.3.1 ZCT-1-Type of Register 31
11.3.2 ZCT-2-Disb 1 Payee Number 31
11.3.3 ZCT-3- Disb 1 Payee Name 31
11.3.4 ZCT-4- Disb 1 Payee Amount 31
11.3.5 ZCT-5- Disb 2 Payee Number 31
11.3.6 ZCT-6- Disb 2 Payee Name 31
11.3.7 ZCT-7- Disb 2 Payee Amount 31
11.3.8 ZCT-8- Disb 3 Payee Number 31
11.3.9 ZCT-9- Disb 3 Payee Name 32
11.3.10 ZCT-10- Disb 3 Payee Amount 32
12. ZER –CBF Error 33
12.1 Function 33
12.2 Table of Fields 33
12.3 Field Notes 33
12.3.1 ZER-1- Error Message 33
13. ZPC – Organisation Details 34
13.1 Function 34
13.2 Table of Fields 34
13.3 Field Notes 34
13.3.1 ZPC-1- Organisation ID 34
13.3.2 ZPC-2- Contract Number 34
13.3.3 ZPC-3- Payee Number 34
13.3.4 ZPC-4- Payment Period 34
13.3.5 ZPC-5- Total Affiliated Practices 34
13.3.6 ZPC-6- Total Registered Patients 35
13.3.7 ZPC-7- Organisation Name 35
14. ZPR – Practice Details 36
14.1 Function 36
14.2 Table of Fields 36
14.3 Field Notes 36
14.3.1 ZPR-1- Practice Name 36
14.3.2 ZPR-2- Practice Identifier 36
14.3.3 ZPR-3- Payee Number 36
15. ZRD – Patient Register Details 37
15.1 Function 37
15.2 Table of Fields 37
15.3 Field Notes 37
15.3.1 ZRD-1-Maiden Name 37
15.3.2 ZRD-2-Residential X Coordinate 37
15.3.3 ZRD-3-Residential Y Coordinate 37
15.3.4 ZRD-4-Residential Status 38
15.3.5 ZRD-5-Postal Address 38
15.3.6 ZRD-6- Mobile/Other Phone 38
15.3.7 ZRD-7- Date of Enrolment 38
15.3.8 ZRD-8- Date of Enrolment Confirmation 38
15.3.9 ZRD-9- Date of Last Consultation 38
15.3.10 ZRD-10- Registration Status 38
15.3.11 ZRD-11- HUHC Number 38
15.3.12 ZRD-12- HUHC Expiry Date 38
15.3.13 ZRD-13- CSC Number 38
15.3.14 ZRD-14- CSC Expiry Date 39
15.3.15 ZRD-15- Meshblock 39
15.3.16 ZRD-16- Quintile 39
15.3.17 ZRD-17- Validation Identifier 39
15.3.18 ZRD-18- DHB 39
15.3.19 ZRD-19-Care Plus Enrolment Status 39
15.3.20 ZRD-20-Care Plus Enrolment Start Date 39
15.3.21 ZRD-21-Care Plus Enrolment End Date 40
ZSA –Grouping Segment 41
16.1 Function 41
16.2 Table of Fields 41
16.3 Field Notes 41
16.3.1 ZSA-1- Grouping Message 41
17. General Implementation 42
17.1 Introduction 42
17.2 Further References 42
Appendix A. References 43
Appendix B. Data Requirement Notes 44
New Zealand Health Address Standard 44
New Zealand Address Examples 45
Appendix C. Sample Files in HL7 Format 46
C.1 Sample Register File 46
C.2 Sample Acknowledgment Files 46
C.2.1 Accept Acknowledgement : 46
C.2.2 Reject Acknowledgement : 47
C.2.3 Error Acknowledgement 48
C.2.4 Validation Acknowledgement 49
Appendix D. Error Codes Listing 51
D.1 Error Types 51
D.2 Error Lists 52
D.2.1 Error Identifiers at Register level 52
D.2.2 Error Identifiers at Segment Level 53
D.2.3 Error Identifiers at Field Level 56
D.2.4 Grouping Codes at Practice Segment level 57
D.2.5 Component Level Error Identifiers 58
Confidential / HL7 Messages Standard Definition (v3.11) ÓHealthPAC, 2009 / Page 431. Brief Description
1.1 Introduction
This document defines messaging and communication standards for the electronic transfer of patient register information between Organisations and HealthPAC.
The requirements for transmitting these registers have been divided into 2 implementation phases. This standard falls into the second phase of the project, and covers transmission of patient registers for Capitation Based Funding. The first stage is to check with HealthPAC that you are eligible to claim the Capitation Based Funding subsidy. To enquire about or request an information pack on Capitation Based Funding, please contact HealthPAC Contact Centre on 0800 252 464, which is to be operational from 20th August 2002. Calls before this time please call Donna Harrison on (04) 381 5300.