EDI-to-CSV Conversion User Guide
By default, all fields from 835/837 are converted to CSV. The converter creates a row for every service line and duplicates payment/claim level fields on every row.
You can customize this default behavior by using one of the pre-configured conversion schemas, or you can create your own custom schema.
The name of the schema can be provided using the schemaName parameter for the API call or the --csv-schema-name option for the CLI tool.
Built-in Conversion Schemas
Default (no explicit name)
The CLI converter will create two files, one with the claim-level fields using header-only schema and another with the service-line fields using lines-only schema.
The API uses the lines-with-header-repeat-first-row schema by default.
lines-with-header-repeat-first-row
Create a single CSV file containing all fields from the header and service lines. The first line for the claim includes all claim-level data; subsequent lines contain only the following fields:
- Id
- PatientControlNumber
- PayerControlNumber (835 only)
This schema is the default for the API edi/csv operation.
It is also used by our UI when selecting “Export/All Fields” from the details screen or “Download CSV/All Fields” from the list screen.
To see examples, go to any example on the site and click “Export/All Fields.”
lines-with-header-repeat-each-row
Create a single CSV file containing all fields from the header and service lines. Claim-level fields repeat on every line.
header-only
Create a single CSV file with claim-level fields.
lines-only
Create a single CSV file with line-level fields.
key-fields
Create a single file with only the most important fields from 835/837.
This schema is used by our UI when selecting “Export/Key Fields” from the details screen or “Download CSV/Key Fields” from the list screen.
To see examples, go to any example on the site and click “Export/Key Fields.”
Here is the list of fields:
835
Claim-level fields:
- Id
- FileName
- PatientControlNumber
- ClaimStatus
- ChargeAmount
- PaymentAmount
- PatientResponsibilityAmount
- DrgCode
- PaymentDate
- CheckOrEftTraceNumber
- TotalAdjAmount
- Adj*ReasonCode
- Adj*Amount
- PayerIdentifier
- PayerName
- CoverageAmount
- PatientIdentifier
- PatientLastName
- PatientFirstName
- ServiceDateFrom
- ServiceDateTo
Line-level fields:
- LineControlNumber
- LineProcedureCode
- LineRevenueCode
- LineChargeAmount
- LinePaidAmount
- LineUnitCount
- LineServiceDateFrom
- LineServiceDateTo
- LineTotalAdjAmount
- LineAdj*ReasonCode
- LineAdj*Amount
- LineAllowedAmount
- LineRemarkCode*
837P
Claim-level fields:
- Id
- FileName
- PatientControlNumber
- ChargeAmount
- PlaceOfService
- FrequencyTypeCode
- TransactionCreationDateTime
- ServiceDateFrom
- ServiceDateTo
- SubscriberIdentifier
- SubscriberLastName
- SubscriberFirstName
- SubscriberPayerIdentifier
- SubscriberPayerName
- PatientPaidAmount
- OtherSubscriberPayerPaidAmount
- Diag*
Line-level fields:
- LineControlNumber
- LineProcedureCode
- LineProcedureModifier*
- LineChargeAmount
- LineUnitCount
- LineServiceDateFrom
- LineServiceDateTo
837I
Claim-level fields:
- Id
- FileName
- PatientControlNumber
- ChargeAmount
- FacilityCode
- FrequencyTypeCode
- TransactionCreationDateTime
- StatementDateFrom
- StatementDateTo
- AdmissionDateAndHour
- SubscriberIdentifier
- SubscriberLastName
- SubscriberFirstName
- SubscriberPayerIdentifier
- SubscriberPayerName
- PriorAuthorizationNumber
- PayerClaimControlNum
- DrgCode
- PrincipalDiag
- AdmittingDiag
- OtherDiag*
- PrincipalProcedure
- OtherProcedure*
Line-level fields:
- LineControlNumber
- LineRevenueCode
- LineProcedureCode
- LineChargeAmount
- LineUnitCount
- LineServiceDateFrom
- LineServiceDateTo
Customizing Conversion Schemas
You can customize the built-in schemas or create your own custom schemas.
The schemas are defined in the csv_conversion.yaml file.
Modifying Conversion Schemas for the CLI Tool
You can find the csv_conversion.yaml file in your installation’s conf folder.
You can change this file directly or copy it into a new file.
Edit the file and update the excludedFields or the includedFields property.
If you created a new file, you will need to define the path to this file using the CSV_SCHEMA_FILE environment variable.
Modifying Conversion Schemas in the API Server
Download the latest schema file from this location. Modify this file and save it to etc/csv folder of the etc volume of the Docker container.
Alternatively, you can save this file in some other location and create a bind mount with the source pointing to your file. The destination has to be under /app directory of the container.
Then define CSV_SCHEMA_DIR environment variable with the new location. If you want to use a different file name, provide the name using CSV_SCHEMA_FILE environment variable.