Simple Types
| Simple Type | Description |
|---|---|
| ActivityOrderingClinician | License number of the clinician who ordered the service or referred the patient for the service. |
| ActivityClinician | License number of the clinician responsible for the activity. In general the Activity Clinician is the person providing the treatment or care for the patient. Exceptions: • for the following services the Activity Clinician is the ordering physician: all types of rehabilitation therapy (includes physiotherapy, speech therapy, occupational therapy, respiratory therapy and dietician services), shockwave therapy, haemodialysis, light therapy & photo-therapy, electro-cautery, labs, x-rays, prescriptions, other tests, such as EEG, Sleep lab & Nerve conduction Studies, Audiometry (effective until ActivityOrderingClinician element is implemented) • the Activity Clinician is the attending consultant physician at the time of discharge of the patient from the hospital if the Activity is an inpatient Service Code or DRG |
| ActivityCode | ActivityCode is the code, specified by ActivityType, for the Activity performed. |
| ActivityDateOrdered | The date and time at which Activity ordered. |
| ActivityDenialCode | The code that indicates the reason for denial or adjustment of authorisation/payment by the Payer. The list of denial/adjustment codes can be found at www.doh.gov.ae/en/Shafafiya/dictionary >> Codes >> Other Codes |
| ActivityGross | Is the total AED amount of the charges included on the Activity.
RemittanceActivityGross includes any patient financial responsibility for the Activity, such as co-pays and deductibles, as well as charges made to other insurers for the Encounter(s) covered by the Activity. |
| ActivityList | ActivityList describes the list price before any adjustments of discounts. |
| ActivityNet | The net charges billed by the provider to the Payer for this Activity. For PriorRequests this is the estimated amount requested, not the amount billed. Note | Some activities will be charged as a line item in a Claim, such as a prescription. Other activities are not charged in their own right. For instance, in a DRG payment system, individual procedures associated with an Encounter may not be charged, but the overall Encounter is charged as a DRG-Activity. Example | If ActivityType is 9, ActivityCode is 311, ActivityQuantity is 1, ActivityNet might be AED 8250.00 Example | If ActivityType is 1, ActivityCode is 309.3, ActivityQuantity is 1, ActivityNet might be 0, if this procedures is claimed as a DRG. Note | For non-paying, non-insured patients, where a pro-forma invoice is created, this should be the gross amount that would have been charged. |
| ActivityPatientShare | Any fee that Payer is expecting the Provider to collect from the patient. |
| ActivityPaymentAmount | For RemittanceAdvice: the amount paid by the payer towards the provider’s Claim. For PriorAuthorization: the amount of guaranteed payment for the activity. Example | A payer received a Claim with ActivityNet amount of AED 460. The payer decides to make deductions of AED 60, and pays the remaining amount. ActivityPaymentAmount is 400. |
| ActivityPriorAuthorizationID | Authorization ID provided by the Payer. In case of electronic prior authorisation contains:- PriorAuthorization.Authorization.IDpayer, or - PriorRequest.Authorization.ID of a relevant prior request, in cases where prior authorisation is not provided within defined time limit |
| ActivityQuantity | Identifies the number of units (quantity) for a specific Activity.
For PriorAuthorizations this refers to the authorized number of units (quantity).
Example 1 | A patient is admitted to the hospital for en elective surgery and was assigned a hospital bed in a private room.
The patient stayed at the hospital for 3 days at the private room. The ActivityQuantity for the private room Activity is 3. |
| ActivityStart | The date and time at which Activity started. For DRG code, it is the date and time of discharge. For PriorRequest/Authorization, this refers to the date on which the Activity is scheduled/prescribed to be started, or dispensed (for type=Authorization).
Note | If the date, but not the time is recorded, the time should be assumed to be 00:00
Restrictions: Needs to be after 01/01/2005, and before the present except PriorRequest/Authorisation transactions. |
| ActivityID | Unique identifier of activity within a claim/prior request. |
| ActivityType | ActivityType classifies the type of activity. 3 = CPT; 4 = HCPCS; 5 = Drug; 6 = Dental; 8 = Service Code; 9 = IR-DRG; 10 = Generic drug. |
| ActivityVAT | The Value Added Tax amount appropriated for the activity. |
| ActivityVATPercent | The Value Added Tax rate. |
| AuthorizationComments | The comments given to add more details on the Authorization. |
| AuthorizationDateOrdered | The date on which the prescription/order is ordered/prescribed.
This is required to check, e.g., validity of a prescription/order, or onset of condition to exclude pre-existing conditions as per policy coverage. |
| AuthorizationDenialCode | The code that indicates the reason for denial or adjustment of authorisation/payment by the Payer. The list of denial/adjustment codes can be found at www.doh.gov.ae/en/Shafafiya/dictionary >> Codes >> Other Codes |
| AuthorizationEmiratesIDNumber | The unique number the government assigns to a citizen. When an EmiratesIDNumber is not available:
000-0000-0000000-0 National without card
111-1111-1111111-1 Expatriate resident without a card
222-2222-2222222-2 Non national, non-expat resident without a card
999-9999-9999999-9 Unknown status, without a card. |
| AuthorizationEnd | The date and time at which Activity ended. |
| AuthorizationID | The unique identifier assigned by the health provider to identify the Authorization; must be globally unique and start with EncounterFacilityID followed by a unique identifier assigned by the facility information system. Example: PF1223-00145677. |
| AuthorizationIDPayer | The unique identifier assigned by an insurer to identify the Authorization. |
| AuthorizationLimit | The total amount available at the time of prior authorization. The communication of the authorization limit is advisory in nature and no provisions or limits are guaranteed for any period of time. |
| AuthorizationMemberID | The patient’s insurance member number as shown on insurance membership card. For self-pay, must be equal to EncounterFacilityID#EncounterPatientID. |
| AuthorizationPayerID | If the patient is claiming insurance cover, this is DOH’s insurance license number If the patient is claiming insurance from an insurance not licensed by DOH, this should be “@” followed by the name of the Insurance If the patient is paying directly for services provided, this should be “SelfPay”
If the patient neither claims insurance nor pays directly for services provided, this should be “ProFormaPayer” Example | H018 Example | @Cigna Medical Example | SelfPay Example | ProFormaPayer. |
| AuthorizationResult | The answer of the inquiry: Yes or No . |
| AuthorizationStart | The date and time at which Activity started. |
| AuthorizationType | Specifies Type using Values: Eligibility, Authorization, Cancellation, Extension, Status Inquiry, Prescription. Based on this Type certain optional elements in the transaction may become mandatory |
| ClaimDateSettlement | The date the payer settles the Claim. This is either the date of payment or the date of decision to reject the claim (PaymentAmount = 0). |
| ClaimDateSettlementReceived | The date the payee receives payment of the Claim.
• If settlement is made in several steps, the latest date of receipt should be used.
• If the settlement value is 0, then this is the date of notification of settlement
• If the provider has designated an intermediary, e.g., another provider or organization to receive payment, it is the date that designated organization receives payment.
Restrictions:
Needs to be between ClaimDateSettled and the present. |
| ClaimDenialCode | The code that indicates the reason for denial or adjustment of authorisation/payment by the Payer. The list of denial/adjustment codes can be found at www.doh.gov.ae/en/Shafafiya/dictionary >> Codes >> Other Codes |
| ClaimEmiratesIDNumber | The unique number the government assigns to a citizen. When an EmiratesIDNumber is not available :
000-0000-0000000-0 National without card
111-1111-1111111-1 Expatriate resident without a card
222-2222-2222222-2 Non national, non-expat resident without a card
999-9999-9999999-9 Unknown status, without a card. |
| ClaimGross | Is the total AED amount of the charges included on the Claim.
ClaimGross includes any patient financial responsibility for the Claim, such as co-pays and deductibles, as well as charges made to other insurers for the Encounter(s) covered by the Claim.
The prices on which ClaimGross are based should reflect the general agreement between the payer and provider for the Claim items for insuree.
Example 1 | A patient visits a clinic for a hip operation. The published list price is AED 8000. However, the insurer has negotiated with the provider a general discount of 10% on the published list price. ClaimGross is AED 7200.
Example 2 | A patient visits a clinic for a routine physical exam which costs AED 2000.The patient pays a co-pay of AED 250. ClaimGross is AED 2000.
Example 3 | A patient visits a clinic for a physical exam (AED 500) and an expensive diagnostic test (AED 1500) in one Encounter. The patient pays a co-pay of AED 250 and claims the diagnostic test from a supplementary insurance, because the primary insurance does not cover this diagnostic test. ClaimGross is AED 2000.
Note | If the claimed amount is not in AED, then value should be converted to AED on the date of ClaimDateSubmission
Restrictions:
Non-negative and greater than or equal to ClaimPatientShare + ClaimNet. |
| ClaimID | The unique number assigned by the health provider to identify the Claim. This is also known as the provider’s Claims reference number. It will be unique for each Claim.
If the patient is not insured and pays out of pocket, this will be the external invoice reference number.
If the patient is a National the Claimid correspond to 'ProFormaPayer'. |
| ClaimIDPayer | The unique number assigned by an insurer to identify the Claim. It helps the provider and payer to locate the Claim.
For non-insured patients this field is empty. |
| ClaimMemberID | The patient’s insurance member number, if the patient is claiming insurance. Otherwise, must be equal to EncounterFacilityID#EncounterPatientID. |
| ClaimNet | The net charges included on the Claim. This is the amount the provider is expected to be paid.
Example | A patient is admitted to the hospital for elective surgery. The surgery is billed on one Claim, and ClaimGross is AED 5000. The patient pays a co-pay of AED 400 (ClaimPatientShare is 400).
The hospital charges the payer for the remaining AED 4600. ClaimNet is 4600. |
| ClaimPatientShare | The amount a patient owes a provider according to the terms of their insurance plan/product. If the patient has no insurance coverage for the visit, they are considered self-pay and liable for the entire amount, per their signed consent for treatment. |
| ClaimPayerID | If the patient is claiming insurance cover, this is DOH’s insurance license number
If the patient is claiming insurance from an insurance not licensed by DOH, this should be “@” followed by the name of the Insurance
If the patient is paying directly for services provided, this should be “SelfPay”
If the patient neither claims insurance nor pays directly for services provided, this should be “ProFormaPayer”
Example | H018
Example | @Cigna Medical
Example | SelfPay
Example | ProFormaPayer. |
| ClaimPaymentAmount | The amount paid by the payer towards the provider’s Claim.
Example | A payer received a Claim with a net amount of AED 4600 (ClaimNet AED is 4600).
The payer decides to make deductions of AED 600, and pays the remaining amount. ClaimPaymentAmount is 4000. |
| ClaimPaymentReference | The unique identifier for the payment transaction, which depending on the way of payment should contain the following values: - The cheque number for payments by a cheque - Bank transfer number for payment by a bank transfer - Payment voucher number for cash payments |
| ClaimProviderID | ClaimProviderID is the DOH license number of the provider claiming from the Payer. This can be a facility or a clinician. If the provider has no DOH license number, the provider should be “@” followed by the name of the provider.
Note | ClaimProviderID is sometimes also known as the billing provider. In general, the facility that hosted the Encounter is also the one that claims from the payer. In these cases, ClaimProviderID is the same as EncounterFacilityID. However, under some circumstances, it is a different party that claims, e.g., a clinician or a different facility.
Example | A hospital group has multiple licensed facilities. The hospital group centralizes billing and claims on the main site. In this case, an Encounter that occurred in a satellite facility (EncounterFacilityID = SatelliteSite) would be billed by the main site, i.e., ClaimProviderID = MainSite). |
| ClaimVAT | The total Value Added Tax amount appropriated for the claim. |
| ContractCollectedPremium | The AED amount received by the Payer as a premium for the term of the Member’s insurance contract. |
| ContractCompanyID | This is the trade license number of the member's company. |
| ContractExpiryDate | This is the date the insurance will expire if it is not renewed.
Restrictions:
• The ContractExpiryDate can not be less than 01/01/1900. |
| ContractGrossPremium | This is the AED amount of the yearly premium, the member has to pay for his insurance policy. The insurer may choose to use the average gross premium for the specific package used. If a contract defines premium for a different time period, a 12-month premium amount should be reported, for example 'monthly premium' * 12, or 'quarterly premium' * 4. |
| ContractPackageName | This is the name of the insurance package taken from a list of all DOH authorized benefit packages. |
| ContractPayerID | Payer ID from where Insurance policy issued. |
| ContractPolicyHolder | The indication of the policy holder.
Restrictions:
1 = Government
2 = Government related services
3 = Other
4 = Private companies < 1000 employees
6 = Private Companies > 1000 employees and <= 50000 employees
7 = Private Companies > 50000 employees and <= 100000 employees
8 = Private Companies > 100000 employees
9 = Embassy
10 = Individual
11 = SME
12 = Diplomat
13 = Dar Zayed
99 = Others. |
| ContractRenewalDate | This is the date the insurance was last renewed. If it is a first time insurance, the date should be the same as used for
ContractStartDate.
Restrictions:
• The ContractRenewalDate can not be a future date
• The ContractRenewalDate can not be less than 01/01/1900. |
| ContractStartDate | This is the date the member first became insured.
Restrictions:
• The ContractStartDate can not be a future date
• The ContractStartDate can not be less than 01/01/1900. |
| ContractStatus | This is the status of member insurance.
• New – The insurance company issuing the contract first time
• Restarted – The same contract restarted after some time
• Renewed – The insurance company renewed the contract
• Corrected – Member correction for the current contract
• Corrected Date - Contract date correction for the current contract
• Updated EmiratesIDNumber – Update the original emiratesIDNumber for the current contract
• Cancelled – Current contract cancellation
• Recon – Historical Records or Missing years
• Newborn – Newborn under Mother Coverage – 30 days
• WarZone - 6 Months Emergency Insurance provided to Members of Warzone Countries
• Visitors – Visitors Emergency Insurance |
| ContractTPAID | License number of TPA that administers the contact the member has contract with. |
| ContractVAT | The total Value Added Tax amount appropriated for the collected premium. |
| ContractVATPercent | The Value Added Tax rate. |
| DateForm | Date data type enforcing the format: "dd/mm/yyyy". |
| DateTimeForm | Date + Time data type enforcing the format: "dd/mm/yyyy HH:MM". |
| DiagnosisCode | The ICD9-CM value for the diagnosis. |
| DiagnosisType | The type of diagnosis being recorded.
| Principal: Identifies the principal diagnosis code (full ICD-9-CM) for the condition established after examination. It will identify the nature of a disease or illness. • Inpatients | Condition established, after study, to be chiefly responsible for occasioning the admission of the patient to the hospital for care. • Ambulatory patients | The condition or problem that explains the clinician’s assessment of the presenting symptoms/problems and corresponds to the tests or services provided. This assessment may be a suspected diagnosis or a rule-out diagnosis and is based on the patient’s presenting history and physical and the physician’s review of symptoms. This may also be a symptom where the underlying cause has yet to be determined
| Secondary: • Inpatients | All conditions that co-exist at the time of admission, or develop subsequently, which affect the treatment received and/or the length of stay. Diagnoses that refer to an earlier episode that have no bearing on the current hospital stay are to be excluded. Conditions should be coded that affect patient care in terms of requiring: Clinical evaluation, therapeutic treatment, diagnostic procedures, extended length of hospital stay, increased nursing care and/or monitoring. • Ambulatory patients | All co-existing conditions, including chronic conditions that exist at the time of the Encounter or visit and require or affect patient management. • External causes of injury, poisoning or adverse affect are coded as supplementary codes to the diagnosis codes of the actual condition such as “Motor Vehicle Accident” that caused a fracture of the tibia. Note | For quality purposes, it is important to be able to track Hospital-acquired infections. The corresponding E-Code is 849.7
| Admitting: The diagnosis that the physician identifies at the time of admission. Note: this diagnosis might differ from EncounterDiagnosisPrincipal.
| ReasonForVisit: The sign or symptom or diagnosis which describes the patient's reason for visit in the outpatient Settings. This is an ICD-9-CM code describing the patient's stated reason for seeking care which cannot be reported with a definitive diagnosis as per CCSC/ICD coding guidelines.
Restrictions: The basis of a comprehensive ICD9-CM list
|
| DxInfoCode | The code value related to the DxInfoType. For POA type, values are: "Y"= Yes, "N"= No, "U"= Unknown, "W"= Clinically Undetermined, "1"=Unreported/Not used. Full description can be found on DSP minutes, decision 260
|
| DxInfoType | The type of additional information for the diagnosis. | Used for POA: Present On Admission (POA) indicator it refers to the associated diagnosis code and is defined as: Present at the time the order for inpatient admission occurs. Conditions that develop during an outpatient encounter, including emergency department, observation, or outpatient surgery, are considered as present on admission. The POA Indicator is applied to the principal diagnosis as well as all secondary diagnoses and the external cause of injury codes that are reported. If a condition would not be coded and reported based on UHDDS definitions and current official coding guidelines, then the POA indicator would not be reported.
|
| EncounterEnd |
In general this is the time the patient ceases to be under the direct care of a responsible clinician
• For inpatients and day patients this would be the discharge date and time.
• For emergency patients this would be the time that the patient was released from the ER
• For PriorRequest/Authorization, this could refer to the date on which the Encounter is expected to end in the future according to the planned activities which could be after TransactionDate.
Note| EncounterEnd is not required for outpatients, even though the field logic applies analogously to other encounter types. |
| EncounterEndType | How the patient was discharged.
1 = Discharged with approval
2 = Discharged against advice
3 = Discharged absent without leave
4 = Discharge transfer to acute care
5 = Deceased
6 = Not discharged
7 = Discharge transfer to non-acute care
8 = Tele-Medicine resulting in Emergency Management
9 = Tele-Medicine resulting in Prescription
10 = Tele-Medicine resulting in Referral
11 = Tele-Medicine resulting in Follow Up
12 = Tele-Medicine resulting in Self Care |
| EncounterFacilityID | License number of the facility responsible for the Encounter. If reported encounter happened in a not licensed facility, must be equal to “@” followed by the name of the facility Restrictions: Needs to listed in www.doh.gov.ae/en/Shafafiya/dictionary >> Licenses >> Facilities or start with “@” . |
| EncounterLocation | The name used by the provider to describe the location where the Encounter took place. If the patient visited an outpatient clinic, this would be the name used by the provider for the particular clinic. In some cases, where the patient was in multiple inpatient locations while in the healthcare facility, the discharge location should be used. If the patient was in multiple clinics on the same day, each visit would typically be a separate Encounter, and the clinic location should be reported for each Encounter.
Example | ENT Clinic
Example | Cardiology Ward 3. |
| EncounterPatientID | The unique number a healthcare provider assigns to a patient.
This is often known as the medical record number. |
| EncounterEligibilityIDPayer | The AuthorizationIDPayer provided by the Insurer/TPA in the latest Eligibility transaction (PriorAuthorization with AuthorizationType=Eligibility) and reported in a ClaimsSubmission. This is used for the Provider to demonstrate in the ClaimSubmission that Payer has confirmed patient’s eligibility. |
| EncounterSpeciality | The predominant specialty of the primary caregiver for the Encounter.
Note | As there are at present no detailed standardized specialty definitions, providers should use their own, pre-existing naming conventions.
Example | Urology
Example | Cardiology. |
| EncounterStart | EncounterStart is the date and time at which the patient comes under the care of a responsible clinician.
• For Elective patients this will typically be the date and time of the visit registration/admission on arrival of the patient at the healthcare facility.
• For Emergency patients this will typically be the date and time of the registration and admission on arrival of the patient at the healthcare facility.
• For Transfer patients between facilities (i.e. inter-hospital transfers), this will typically be the date and time of the visit registration and admission on arrival of the patient at the receiving healthcare facility.
• For Livebirth this will typically be the date and time of the registration and admission of the newborn at the healthcare facility. The Encounter start will also be the date and time of birth.
• For Stillbirth this will typically be the date and time of the registration of the stillborn at the healthcare facility. The Encounter start will also be the date and time of stillbirth.
• For Death on arrival this will typically be the date and time of the visit registration on arrival of the patient at the healthcare facility for pronouncement.
• For PriorRequest/Authorization, this could refer also to the date on which the Encounter is scheduled/prescribed to be started (e.g. for elective procedures) Restrictions: Needs to be after 1/1/1900 and before the present except for PriorRequest/Authorizations of future services where it could be after TransactionDate and after the present
Restrictions:
Needs to be after 1/1/1900 and before the present. |
| EncounterStartType | EncounterStartType is
1 = Elective, i.e., an Encounter is scheduled in advance
2 = Emergency
3 = Transfer admission from acute care
4 = Live birth
5 = Still birth
6 = Dead On Arrival
7 = Continuing Encounter
8 = Transfer admission from non-acute care
Example 1 | An urgent referral from an outpatient clinic to the cardiology ward, i.e., not scheduled, would be considered as EncounterStartType 2 = Emergency, and EncounterType would be 3 = Inpatient bed + No emergency room
Example 2 | A patient is referred to a consultant, by her general practitioner, and an appointment is scheduled for two weeks later. This outpatient appointment has EncounterStartType 1 = Elective.
Example 3 | Provider claims long-term care encounter in two claims:
Claim 1: EncounterStart 01/01/2011 10:00, EncounterEnd 31/01/2011 23:59, EncounterStartType 3=Transfer admission from acute care, EncounterEndType 6=Not discharged
Claim 2: EncounterStart = 01/02/2011 00:00, EncounterEnd = 13/02/2011 13:00, EncounterStartType = 7-Continuing Encounter, EncounterEndType = 5-Deceased
Restrictions: Only values allowed are 1 = Elective 2 = Emergency 3 = Transfer 4 = Live birth 5 = Still birth 6 = Dead On Arrival 7 = Continuing Encounter 8 = Transfer admission from non-acute care. |
| EncounterTransferDestination | EncounterTransferDestination is the healthcare facility to which a hospital transfer is made at the end of an Encounter (EncounterEndType = 4 Transfer)
• This is DOH’s unique facility license number.
• If the patient has insurance coverage, enter DOH’s insurance ID number
• If the patient does not have insurance and paying in cash for services provided, enter (SelfPay) in this field.
• If the patient is neither insured by a DOH insurance nor paying SelfPay, nor treated for Free – ProFormaPayer
• If another insurance, then @ “Name of the insurance”
Restrictions:
The latest version of these attributes can be downloaded from www.doh.gov.ae/en/Shafafiya/dictionary >> Licenses >> Facilities. See “How to submit data to DOH” for further details. |
| EncounterTransferSource | EncounterTransferSource is the healthcare facility from where a hospital transfer originated (EncounterStartType = 3 Transfer)
• The originating healthcare facility is described by DOH’s unique facility license number.
• If the patient has insurance coverage, enter DOH’s insurance ID number
• If the patient does not have insurance and is paying in cash for services provided, enter (SelfPay) in this field.
• If the patient is neither insured by a DOH insurance nor paying SelfPay, nor treated for Free – ProFormaPayer
• If another insurance, then @ “Name of the insurance”
Restrictions:
The latest version of these attributes can be downloaded from www.doh.gov.ae/en/Shafafiya/dictionary >> Licenses >> Facilities. See “How to submit data to DOH” for further details. |
| EncounterType | 1 = No Bed + No emergency room
2 = No Bed + Emergency room
3 = Inpatient Bed + No emergency room
4 = Inpatient Bed + Emergency room
5 = Daycase Bed + No emergency room
6 = Daycase Bed + Emergency room
7 = Nationals Screening
8 = New Visa Screening
9 = Renewal Visa Screening
12 = Home
13 = Assisted Living Facility
15 = Mobile Unit
41 = Ambulance - Land
42 = Ambulance - Air or Water
10 = Telemedicine
Note | There are different ways to classify Encounters as inpatients, daycases, emergencies and outpatients. They vary according to whether the Encounter went past midnight, lasted for more than 24 hours, involved a hospital bed and whether they involved an emergency room. To benchmark with different countries, one needs to know, whether the patient was in the emergency room, and whether the patient occupied a hospital bed.
Inpatient bed | A licensed bed approved by the competent authority which is assigned to a patient who is arriving to a health care facililty for an emergent, urgent or elective/planned Encounter. Beds assigned temporarily for "holding" purposes in a no bed situation may be designated and included in hospital occupancy rate calculation (e.g. emergency room, recovery room). Only beds included in the licensed inpatient bed complement will be used for purposes of hospital occupancy rate calculation. Beds may have an associated accommodation value such as private (i.e. single bed/room) or shared (i.e. multiple beds/room).
Beds included in the inpatient bed complement:
• Beds in general wards or units set up and staffed for inpatient services
• Beds in special care units set up and staffed for inpatient services such as intensive care, coronary care, neonatal intensive care, pediatric intensive care, medical and surgical step-down, burn units
Beds excluded from the inpatient bed complement:
• Beds/cots for healthy newborns
• Beds in Day Care units, such as surgical, medical, pediatric day care, interventional radiology
• Beds in Dialysis units
• Beds in Labor Suites (e.g. birth day beds, birthing chairs)
• Beds in Operating Theatre
• Temporary beds such as stretchers
• Chairs, Cots or Beds used to accommodate sitters, parents, guardians accompanying patients or sick children and healthy baby accompanying a hospitalized breast feeding mother
• Beds closed during renovation of patient care areas when approved by the competent authority
Daycase bed | Daycase beds, also known as observation beds, are beds used in Day Care units such as surgical, medical, pediatric day care interventional radiology. They are not included in the inpatient bed complement.
Restrictions:
Only values allowed are:
1 = No Bed + No emergency room
2 = No Bed + Emergency room
3 = Inpatient Bed + No emergency room
4 = Inpatient Bed + Emergency room
5 = Daycase Bed + No emergency room
6 = Daycase Bed + Emergency room
7 = Nationals Screening
8 = New Visa Screening
9 = Renewal Visa Screening
12 = Home
13 = Assisted Living Facility
15 = Mobile Unit
41 = Ambulance - Land
42 = Ambulance - Air or Water
10 = Telemedicine. |
| HeaderDispositionFlag | Flag to determine whether the submission file is sent to the receiver or only checked against the validation rules.
The following values are allowed in the production environment:
|‘PRODUCTION’ - upon successful validation the transaction file is saved in the Post Office and made available for download by the receiver
|‘TEST’ - the validation engine checks the data in the submission against all production-version validation rules and provides an error report to the user; the transaction file is immediately discarded without being sent to the receiver
In the Public Test Environment the following values are allowed:
|'PTE_SUBMIT' - upon successful validation the transaction file is saved in the Post Office and made available for download by the receiver
|‘PTE_VALIDATE_ONLY’ - the validation engine checks the data in the submission against all validation rules in the PTE version and provides an error report to the user; the transaction file is immediately discarded without being sent to the receiver
The rules for the Public Test Environment are described at www.doh.gov.ae/en/Shafafiya/dictionary. |
| HeaderReceiverID | DOH license number of the Provider, Insurer or TPA receiving information. If the receiving healthcare entity is not licensed by DOH, enter “@” followed by the name of the entity.
For transaction pairs the receiver of the first transaction must be the sender of the second transaction, e.g., if a TPA receives a ClaimSubmission from a provider, then that TPA (not the insurer) must send the RemittanceAdvice to the provider. |
| HeaderRecordCount | The number of records contained in the XML document at the highest level. Examples: The number of Person elements in the PersonRegister file. The number of Claim elements in the ClaimSubmission file. |
| HeaderSenderID | DOH license number of the Provider, Insurer or TPA sending information. If the sending healthcare entity is not licensed by DOH, enter “@” followed by the name of the entity.
For transaction pairs the receiver of the first transaction must be the sender of the second transaction, e.g., if a TPA receives a ClaimSubmission from a provider, then that TPA (not the insurer) must send the RemittanceAdvice to the provider. |
| HeaderTransactionDate | System generated date and time specifying when the transaction was generated. |
| MemberID | Insurer's identifier for its member. The same MemberID cannot be assigned to more than one person. In PersonRegister transactions submitted by Providers, such as to report self pay, MemberID must be equal to ClaimMemberID reported in related claims (EncounterFacilityID#EncounterPatientID). |
| MemberRelation | The information about the family relationships: Principal, Spouse, Child, Parent, Other. |
| MemberRelationTo | The information about the MemberID of the principal member of the family. |
| MemberRelationToEmiratesIDNumber | The information about the Emirates ID Number of the principal member of the family. |
| MemberRelationToUnifiedNumber | The information about the Unified Number of the principal member of the family. |
| ObservationCode | The code describing the Observation value. |
| ObservationType | |
| ObservationValue | The observed value of the Activity.
Restriction:
Must be expressed in SI Units. |
| ObservationValueType | Unit of measure for the Observation.Value. |
| PersonBirthDate | Is the date on which a person was born or is officially deemed to have been born.
In cases, where despite best efforts PerspnBirthDate is not known, but the age is known; then the birth date should be assumed to be on the 1st of January of the current year, minus the age of the person
Example | A patient arrives on January 8th 2008 and Claims he is 64 years old, but does not know his date of birth. The PatientBirthDate should be assumed to be 01/01/1944.. |
| PersonCity | The person’s actual city of residence. |
| PersonCityCode | The person’s actual city of residence code, as per MOI updated lookup. |
| PersonContactNumber | This is the telephone contact number provided by the patient. If multiple numbers are available, the mobile phone number should be used.
If multiple mobile phone numbers are provided, it should be the first mentioned number, which is personal to the patient. |
| PersonCountryOfResidence | Name of the Person's country of usual residense. Includes value from the column 'Country' at www.doh.gov.ae/en/Shafafiya/dictionary >> Codes >> Other Codes >> Nationality
Example: United Arab Emirates |
| PersonEmirateofResidence | Code of the Person's Emirate of usual residense, If the Person is a resident of UAE. Includes value from the column 'Code' at www.doh.gov.ae/en/Shafafiya/dictionary >> Codes >> Other Codes >> Emirate
Example: If the person is a resident of Abu Dhabi, Person.EmirateOfresidence=1 |
| PersonEmiratesIDNumber | The unique number the government assigns to a citizen. When an EmiratesIDNumber is not available :
000-0000-0000000-0 National without card
111-1111-1111111-1 Expatriate resident without a card
222-2222-2222222-2 Non national, non-expat resident without a card
999-9999-9999999-9 Unknown status, without a card. |
| PersonFirstName | The patient’s first name, as spelled in the passport. |
| PersonFirstNameAr | The patient’s first name in Arabic, as spelled in the passport. |
| PersonFirstNameEn | The patient’s first name in English, as spelled in the passport. |
| PersonGender | The patient’s gender
Restrictions:
Only values allowed are
1 = male
0 = female
9 = unknown |
| PersonLastnameAr | The patient’s last name in Arabic, as spelled in the passport. |
| PersonLastnameEn | The patient’s last name in English, as spelled in the passport. |
| PersonMiddleNameAr | The patient’s middle name in Arabic, as spelled in the passport. |
| PersonMiddleNameEn | The patient’s middle name in English, as spelled in the passport. |
| PersonNationality | The current nationality of the person, as defined by the passport.
Restrictions
Only values from the reference list of nationalities are allowed.
The latest List of Nationalities can be downloaded from www.doh.gov.ae/en/Shafafiya/dictionary under Codes/Codes. |
| PersonNationalityCode | The current nationality code of the person, as per MOI updated lookup. |
| PersonPassportNumber | The passport number, or if not available, the National ID. |
| PersonSponsorNameAr | An employer or Individual Arabic name that offers a group health plan to its employees or members |
| PersonSponsorNameEn | An employer or Individual English name that offers a group health plan to its employees or members |
| PersonSponsorNumber | An employer or Individual Number that offers a group health plan to its employees or members |
| PersonUnifiedNumber | Unique number issued by MOI to identity resident of UAE uniquely. |
| ResubmissionAttachments | |
| ResubmissionComment | |
| ResubmissionType | The type of resubmission of a claim or prior request. Value ‘legacy’ is not allowed for PriorRequest. |
| TimeForm | Time data type enforcing the format: "HH:MM". |
| PersonSpecialNationality | Special Nationality Identification. |
| PersonPrivileges | Person Privileges. |
| PersonCOCReferenceNumber | Member COC Reference Number. |
| PersonBirthCertificateNumber | Baby's Birth Certificate Number. |