DA0 Record Entry Field Locations

Payer Data 1

Number	Position	Field Name	Data Entry Screen
01	1-3	Record Type	(Auto Fill)
02	4-5	Sequence Number	Patient List > Insurance button > General tab > Priority
03	6-22	Patient ID	(See CAO Record Patient ID)
04	23	Claim Filing Indicator	Patient List > Insurance button > ECS tab > Claim Filing Indicator
05	24	Payment Source	Setup > Lookup Lists > Carriers > [Change] > ECS tab > Payment Source   and Patient List > Insurance button > ECS tab > Payment Source
06	25-26	Insurance Type Code	Setup > Lookup Lists > Carriers > [Change] > ECS tab > Insurance Type   and Patient List > Insurance button > ECS tab > Insurance Type
07	27-31	National Payer Organization ID	Setup > Lookup Lists > Carriers > [Change] > ECS tab > Payer Organization ID
08	32-35	National Payer Claim Office Number	Setup > Lookup Lists > Carriers > [Change] > ECS tab > Claim Office Number
09	36-68	Payor Name	Patient List > Insurance button > Eligibility tab > Plan Name
10	69-88	Policy Group Number	Patient List > Insurance button > Eligibility tab > Policy Group Number
11	89-121	Group Name	Patient List > Insurance button > ECS tab > Plan/Group Name
12	122	PPO/HMO/Partnership Indicator	Setup > Lookup Lists > Carriers > [Change] > ECS tab > HMO/PPO Indicator   and Patient List > Insurance button > ECS tab > HMO/PPO
13	123-137	PPO/HMO ID Number	Setup > Lookup Lists > Carriers > [Change] > ECS tab > PPO ID   and Patient List > Insurance button > ECS tab > PPO ID
14	138-152	Prior Authorization Number	Patient List > Insurance button > Authorization button > Authorization tab > Authorization Number
15	153	Patient Signature Indicator	Patient List > [Change] > Claims tab > Payment of Benefits
16	154	Patient Signature Source	Patient List > [Change] > Claims tab > Signature Source
17	155-156	Patient Relationship To Insured	Patient List > Insurance button > General tab > Relationship
18	157-181	Patient ID/Medicare Number	Patient List > [Change] > Claims tab > National Patient ID Number   and Patient List > Highlight Patient > Insurance button > Elegibility tab > Insurance ID
19	182-201	Insured Last Name	Patient List > Insurance button > General tab > Last
20	202-213	Insured First Name	Patient List > Insurance button > General tab > First Name
21	214	Insured Middle Initial	Patient List > Insurance button > General tab > MI
22	215-217	Insured Generation	Patient List > Insurance button > General tab > Generation
23	218	Insured Gender	Patient List > Insurance button > General tab > Sex
24	219-226	Insured Date of Birth	Patient List >Insurance button > General tab > Date of Birth
25	227	Employment Status	Patient List > Insurance button > Employment tab > Status
26	228	Supplemental Insurance Indicator	Patient List > Insurance button > [Change] > ECS tab > Supplemental Insurance
27	229-235	Title 19 Identifier	Setup > Lookup Lists > Carriers > [Change] > ECS tab > Insurance Location   and Patient List > Insurance button > ECS tab > Insurance Location
28	236-260	Medicaid ID Number	Patient List > Insurance button > Eligibility tab > Medicaid ID
29	261-285	Supplemental Patient ID	Patient List > Insurance button > ECS tab > Supplemental ID
30	286	Assignment for 4081 Claim	Patient List > Insurance button > ECS tab > Assignment 4801 Code
31	287	COB Routing Indicator	Patient List > Insurance button > ECS tab > COB Routing Indicator
32	288-320	Filler National	(Not Supported)