Client file specifications

Client files imported to Axiom Contract Management must meet the specifications detailed in the following tables for each file type.

Claim data

Institutional claims 837i (required) Description
Format 837i files must adhere strictly to the 5010 standards. All claims must be “scrubbed.” Scrubbed claims typically come from a claims clearinghouse (E-Premis, Emdeon, WebMD, CareMedic, etc.).
Frequency Daily. Claim files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s billing cycle. The folder should be named \\servername\KHData\Hospital\837i5010.
Naming convention Institutional files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDD837i.txt).

 

Professional claims 837p (optional) Description
Format 837p files must adhere strictly to the 5010 format standards.
Frequency Daily. Claim files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s billing cycle. The folder should be named \\servername\KHData\Hospital\837p5010.
Naming convention Professional files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDD837p.txt).

Financial data

Institutional Payments (required) Description
Format Flat ASCII text file or Pipe (|) Delimited. Payments should be positive values, reversals would be negative values.
Requested fields

Required:

  • Account #

  • Posting Date

  • Payment Amount

Optional:

  • UCRN/Claim Number
  • Payer Code

  • Payment Date

  • Posting Code/Transaction Code
Filter All records excluding payments received for professional services (services billed on 837p).
Frequency Daily. Files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s actual posted payments. The folder should be named \\servername\KHData\Hospital\Pay.
Naming convention Institutional Payment files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDDPayI.txt).

 

Institutional Adjustments (required) Description
Format Flat ASCII text file or Pipe (|) Delimited. Adjustments should be positive values, reversals should be negative values.
Requested fields

Required:

  • Account #

  • Posting Date
  • Adjustment Amount

Optional:

  • UCRN/Claim Number
  • Payer Code
  • Payment Date
  • Posting Code/Transaction Code
Filter Adjustment Postings. All records excluding adjustments received for professional services (services billed on 837p).
Frequency Daily. Files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s postings. The folder should be named \\servername\KHData\Hospital\Adj.
Naming convention Institutional Contractual (adjustment) files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDDAdjI.txt).

 

Professional Payments (optional) Description
Format Flat ASCII text file or Pipe (|) Delimited. Payments should be positive values, reversals would be negative values.
Requested fields

Required:

  • Account #

  • Posting Date
  • Payment Amount

Optional:

  • UCRN/Claim Number
  • Payer Code
  • Payment Date
  • Posting Code/Transaction Code
Filter All records excluding payments received for institutional services (services billed on 837i).
Frequency Daily. Files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s postings. The folder should be named \\servername\KHData\Hospital\Payp.
Naming convention Professional Payment files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDDPayP.txt).

 

Professional Adjustments (optional) Description
Format Flat ASCII text file or Pipe (|) Delimited. Adjustments should be positive values, reversals should be negative values.
Requested fields

Required:

  • Account #

  • Posting Date
  • Adjustment Amount

Optional:

  • UCRN/Claim Number
  • Payer Code
  • Payment Date
  • Posting Code/Transaction Code
Filter Adjustment Postings. All records excluding adjustments received for institutional services (services billed on 837i).
Frequency Daily. Files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s postings. The folder should be named \\servername\KHData\Hospital\Adjp.
Naming convention Professional Contractual (adjustment) files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (Example: YYYYMMDDAdjP.txt).

Additional data

Institutional Primary Insurance Plan Code (required) Description

Format

 Flat ASCII text file or Pipe (|) Delimited.
Requested fields

Required:

  • Account #
  • Primary Insurance Plan Code

Optional:

  • UCRN/Claim number
Filter
  • Primary Insurance Only
  • Date criteria based on 6 - 12 month sliding window (today minus 6 months)
Frequency Daily. To be dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s billing cycle. The folder should be named \\servername\KHData\Hospital\Ins.
Naming convention Files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (Example: YYYYMMDDPlanI.txt).

 

Institutional Primary Insurance DRG Code (required) Description

Format

 Flat ASCII text file or Pipe (|) Delimited. DRG codes should be zero filled to 3 characters. For example, DRG 57 should be 057.
Requested fields Required:
  • Account #
  • Primary Insurance DRG Code

Optional:

  • UCRN/Claim Number
Filter
  • Exclude Professional Accounts

  • Primary Insurance Only

  • Date criteria based on 6 - 12 month sliding window (today minus 6 months)
Frequency Daily. Files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s billing cycle. The folder should be named \\servername\KHData\Hospital\DRG.
Naming convention Files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDDdrg.txt).

 

Claim Number Mapping File (optional) Description

Format

 Flat ASCII text file or Pipe (|) Delimited.
Requested fields

This file is needed if the claim number on the claim does not match the posting files from the hospital system.

Required:
  • Account #
  • UCRN/Claim Number
Filter Date criteria based on 6 month sliding window (today minus 6 months).
Frequency Daily. Files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s billing cycle. The folder should be named \\servername\KHData\Hospital\Map.
Naming convention Files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDDUCRN.txt).

 

User Defined Fields (optional) Description

Format

 Flat ASCII text file or Pipe (|) Delimited.
Requested fields Required:

  • Account #

  • User Defined Field (UDF)
Filter Date criteria based on 6 - 12 month sliding window (today minus 6 months)
Frequency Daily. Files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s billing cycle. Each user defined field feed needs a unique folder. These folders should be named \\servername\KHData\Hospital\UDF# where # is the number of the UDF.
Naming convention Files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDDudf1.txt).

 

Professional Primary Insurance Plan Code (optional) Description

Format

 Flat ASCII text file or Pipe (|) Delimited.
Requested fields Required:

  • Account #

  • Primary Insurance Plan Code

Optional:

  • UCRN/Claim Number
Filter
  • Exclude Institutional Accounts
  • Primary payor only
Frequency Daily. Files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s billing cycle. The folder should be named \\servername\KHData\Hospital\InsP.
Naming convention Files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDDPlanP.txt).

Remittance data

Institutional and Professional 835 (optional) Description

Format

 835 files must adhere strictly to the 5010 standards. These files should come from the payer and not be edited.
Frequency Daily. 835 files are dropped to predetermined import folder locations on the Axiom Contract Management server on a daily basis for the previous day’s billing cycle. The folder should be named \\servername\KHData\Hospital\8355010.
Naming convention Institutional files must be unique text files and must not have any spaces or special characters in the name. Syntellis requires that each file have a unique name concatenated with a date stamp for the day it was created (example: YYYYMMDD835.txt).
See also