EHI Export Data Dictionary

HC_BlngStmtDOS_Form

Detailed Descriptions for Health Charge Billing Statement Date of Service Form

24 columns Original: HC_BlngStmtDOS_Form Data Dictionary.html Checked Nov 11, 2026, 7:22 PM CST

Column	Expanded name	Description
`BlngStmtDOS_FormID`	Billing Statement Date Of Service Form Details	A unique identifier for the details of the billing statement corresponding to a specific date of service form.
`AcctHldrID`	Account Holder Details	Identifies the details of the account holder responsible for the payment or charged for the services rendered.
`AgingPeriod`	Aging Period	Time elapsed since the charge was posted, typically used to categorize overdue payments.
`Amt`	Amount	The total amount charged for the services before any adjustments or payments.
`AmtIns`	Amount Insurance	The portion of the total amount that is expected to be paid by the patient's insurance.
`AmtPt`	Amount Patient	The portion of the total amount that is expected to be paid out-of-pocket by the patient.
`AmtAdj`	Amount Adjustment	Any adjustments made to the total amount charged, which could include discounts or corrections.
`AmtAdjIns`	Amount Adjustment Insurance	Adjustments made to the insurance portion of the charge, often due to negotiated payment rates or claim denials.
`AmtAdjPt`	Amount Adjustment Patient	Adjustments made to the patient's portion of the charge, possibly including discounts or financial assistance.
`AmtBal`	Amount Balance	The remaining balance of the total charge after payments and adjustments have been applied.
`AmtBalIns`	Amount Balance Insurance	The remaining balance from the insurance portion of the charge after their payments and adjustments.
`AmtBalPt`	Amount Balance Patient	The remaining balance from the patient's portion of the charge after their payments and adjustments.
`AmtPmt`	Amount Payment	The total payments made towards the charge by all parties.
`AmtPmtIns`	Amount Payment Insurance	Payments made by the insurance towards the charge.
`AmtPmtPt`	Amount Payment Patient	Payments made by the patient towards the charge.
`BlngStmtMainID`	Billing Statement Main Details	The main identifier for the billing statement that may include multiple services or date of service forms.
`BlngStmtMbrID`	Billing Statement Member Details	The identifier for the member or patient to whom the billing statement is related.
`DateOfService`	Date Of Service	The specific date when the medical service was provided to the patient.
`IsDisplayDetails`	Is Display Details	A flag indicating whether the detailed information of the billing statement is to be displayed or not.
`PtID`	Patient Details	A unique identifier for the patient's account or record within the healthcare system.
`PtNmFirst`	Patient Name First	The first name of the patient as stored in the healthcare records.
`ZUChkSum`	Audit Checksum	A checksum value used for auditing purposes to ensure data integrity.
`ZUDate`	Audit Date	The date when the data was last audited or modified for record-keeping.
`ZULogonHisID`	Audit Logon History Details	Identifier of the audit log entry that records the details of user logon history for security and tracking.