Patient Import Service

Import Request

Request a Patient Import

Please fill out the form below to request a patient import. Read the CSV format requirements below before uploading your file.

Your Name *

Account Site ID *

Contact Phone Number *

Preferred Import Date *

Upload Patient List (CSV) *

Accepted formats: .CSV, .XLS, .XLSX. See column header requirements below.

Before uploading: Please read the CSV format requirements below carefully. Your file must include a header row with the correct column keywords. Required fields are marked in red.

Questions about your import? Call us at 954-237-3700 or contact support.

Header Keyword	Column Data Description
FirstName	Patient first name
LastName	Patient last name
ExternalId	External ID from your system
FirstLastName	First and last name combined in one column
LastFirstName	Last name and first name combined in one column
MiddleName	Middle name
Address	Street address
Address2	Suite or apartment number
City	City
State	State (abbreviation or full name)
Zip	ZIP / Postal code
CityStateZip	City, State, ZIP combined (e.g., Davie FL 33324)
SSN	Social Security Number
HomePhone	Home phone number
WorkPhone	Work phone number
CellPhone	Cell / mobile phone number
DOB	Date of birth
DateOfBirth	Date of birth (alternate keyword)
DriversLicense	Driver's license number
Email	Patient email address
Gender	Patient gender
GroupName	Group name
RxBin	Insurance BIN number
PCN	Insurance Processor Control Number (PCN)
Group	Insurance group number
CardId	Insurance card ID
CardName	Insurance cardholder name
PersonCode	Insurance person code
RelationCode	Insurance relation code
DOI	Date of Injury
Date of Injury	Date of Injury (alternate keyword)
Claim #	Claim number
Claim Number	Claim number (alternate keyword)
ICD9	ICD-9 codes, separated by commas for multiple
ICD10	ICD-10 codes, separated by commas for multiple
Notes	Patient notes
Employer Name	Employer name
Employer Address	Employer street address
Employer Address2	Employer suite / unit
Employer City	Employer city
Employer State	Employer state
Employer Zip	Employer ZIP code
Employer Phone	Employer phone number
Payer Name	Payer / insurance company name
Payer Address	Payer address
Payer Address2	Payer suite / unit
Payer City	Payer city
Payer State	Payer state
Payer Zip	Payer ZIP code
Payer Phone	Payer phone number
Attorney Practice Name	Attorney practice name
Attorney Name	Attorney name
Attorney Address	Attorney address
Attorney City	Attorney city
Attorney State	Attorney state
Attorney Zip	Attorney ZIP code
Attorney Phone	Attorney phone number
Attorney Fax	Attorney fax number
Attorney Email	Attorney email address

Header Keyword

Column Data Description

FirstName

Patient first name

LastName

Patient last name

ExternalId

External ID from your system

FirstLastName

First and last name combined in one column

LastFirstName

Last name and first name combined in one column

MiddleName

Middle name

Address

Street address

Address2

Suite or apartment number

City

State

State (abbreviation or full name)

Zip

ZIP / Postal code

CityStateZip

City, State, ZIP combined (e.g., Davie FL 33324)

SSN

Social Security Number

HomePhone

Home phone number

WorkPhone

Work phone number

CellPhone

Cell / mobile phone number

DOB

Date of birth

DateOfBirth

Date of birth (alternate keyword)

DriversLicense

Driver's license number

Patient email address

Gender

Patient gender

GroupName

Group name

RxBin

Insurance BIN number

PCN

Insurance Processor Control Number (PCN)

Group

Insurance group number

CardId

Insurance card ID

CardName

Insurance cardholder name

PersonCode

Insurance person code

RelationCode

Insurance relation code

DOI

Date of Injury

Date of Injury (alternate keyword)

Claim #

Claim number

Claim Number

Claim number (alternate keyword)

ICD9

ICD-9 codes, separated by commas for multiple

ICD10

ICD-10 codes, separated by commas for multiple

Notes

Patient notes

Employer Name

Employer name

Employer Address

Employer street address

Employer Address2

Employer suite / unit

Employer City

Employer city

Employer State

Employer state

Employer Zip

Employer ZIP code

Employer Phone

Employer phone number

Payer Name

Payer / insurance company name

Payer Address

Payer address

Payer Address2

Payer suite / unit

Payer City

Payer city

Payer State

Payer state

Payer Zip

Payer ZIP code

Payer Phone

Payer phone number

Attorney Practice Name

Attorney practice name

Attorney Name

Attorney name

Attorney Address

Attorney address

Attorney City

Attorney city

Attorney State

Attorney state

Attorney Zip

Attorney ZIP code

Attorney Phone

Attorney phone number

Attorney Fax

Attorney fax number

Attorney Email

Attorney email address

Request a Patient Import

CSV File Format Requirements

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