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      Import NEMSIS XML Documents / Using AngelTrack Without Its PCR

      Learn how to perform importing of NEMSIS XML documents directly into AngelTrack's billing workflow.

      If you use a different product for your PCR, you can import that PCR's charts directly into AngelTrack's billing workflow. This allows you to use AngelTrack's billing system and maybe also its CAD in situations where you are required by contract to use some other PCR for your patient charting.

      Configuring AngelTrack to Run Without Its PCR

      To configure your AngelTrack server for use without its PCR, perform the following steps:

      1. From the Home page, navigate to the Settings page.
      2. Select the "Service Levels Configuration" item.
      3. Mark all service levels as "Not Reportable". That will disable all state data validation rules and the state uploader(s).

      Your other PCR is responsible for satisfying any state data validation rules, and for performing all necessary state uploads.

      Training Crew Members on AngelTrack Without Its PCR

      If you have crew members who have access to AngelTrack, they will still be able to visit their Crew Home Page, see their recent calls, and even open the PCRs to see what AngelTrack imported from your other PCR.

      Teach your crew members the following:

      • Any modifications to PCR data must be made in the other PCR, and then re-imported to AngelTrack, because the other PCR is responsible for state uploads and therefore needs to have all pertinent data.
      • Likewise QA review will occur in the other PCR, not in AngelTrack.
      • Even though your crew members have already input their patch numbers into the other PCR, they must also maintain their certificate records in AngelTrack. This is mandatory because AngelTrack uses their certificate numbers to match up the assigned crew IDs in the data arriving from the other PCR. If the other PCR says, "Crew member 012345 and 67890 ran this call," AngelTrack must be able to find two crew members who have certificate numbers or driver's license numbers 012345 and 67890, otherwise the import will fail.

      Manual Import of NEMSIS XML Data

      To manually import a NEMSIS XML document into AngelTrack's billing system, perform these steps:

      1. Login to AngelTrack with Biller or Captain privileges.
      2. Visit the Billing Home page.
      3. On the "Compliance" menu, find and click the "NEMSIS XML Import" link.
      4. Review the available import options and make any changes as necessary; the options are explained below.
      5. Click the button to upload your document.
      6. Wait while the importer processes the document.
      7. Review the result messages. If any errors occurred, if you don't understand the reason, then take a screenshot and contact AngelTrack support.

      The most common cause of a failed import is the inability of AngelTrack to match the vehicle and crew specified in the imported PCR. This issue is described in greater detail below.

      AngelTrack has a file size limit on its file uploads, in order to protect against denial-of-service attacks. If your NEMSIS XML document exceeds this limit, you will receive an error message. This normally occurs only for multi-trip XML documents, in which case, see if you can obtain an XML document for each trip separately, rather than a single large combined XML.

      Automatic Import of NEMSIS XML Data

      AngelTrack has an API by which NEMSIS XML documents can be automatically pushed into the system. The API accepts plain NEMSIS XML documents and has very simple authentication -- using an AngelTrack API key.

      A technical consultant or contract programmer could easy create a simple uploader tool for this task. All of the documentation for the API is available here: NEMSIS Import API Guide

      The more challenging part of connecting a third-party PCR to AngelTrack's billing system is the automated extraction of completed NEMSIS XMLs from the other PCR. Every PCR software app is different, and each will have its own way of retrieving completed charts, so AngelTrack does not provide a general-purpose trip extractor that can pull from any third-party PCR. You must contract out that job yourself, or consult with AngelTrack LLC to study the task and reccommend an implementation plan.

      Assigned Vehicle and Crew During NEMSIS Import

      If you import a NEMSIS XML document that represents a completed call, the XML will include the callsign of the responding vehicle, and the patch numbers of the responding crew members. (To learn the technical details of how this data is represented inside a NEMSIS XML document, please refer to the NEMSIS Import API Guide.)

      During import, AngelTrack will attempt to match this information with its own records, in order to create and link the proper shift record to the trip. This means that your AngelTrack server must already have the following records created ahead of time:

      • Vehicles: Name or callsign must exactly match what's in your PCR application.
      • Employees: EMS certificate numbers must exactly match what's in your PCR application. (Alternatively, you can input an employee's patch number in the "Provider-issued 
        ID number" field of their employee record.)
      • Stations: There must be at least one station in each of your zones, assumed to be the home of any vehicles marked "float" for calls originating inside zone.

      AngelTrack cannot create vehicle and employee records on-the-fly, because vehicle records and employee records require large amounts of additional information (sometimes called "DEM" information) that is not present in the NEMSIS XML file and which cannot be auto-constructed. Your supervisors must input all the necessary vehicles, crew members, and crew certificates, and keep them updated so that it always matches what's in your PCR application.

      If you are importing wheelchair-van trips, your wheelchair drivers must have patch numbers. If your state does not issue wheelchair-van driver certificates, then AngelTrack can find them by their state driver's license numbers instead, as long as it has those numbers on file.

      If you import the NEMSIS XML for a completed call but AngelTrack cannot match a vehicle and at least one crew member, then AngelTrack would have to import the call as a cancellation, since every completed non-cancelled call in AngelTrack must have an assigned shift. In this situation  AngelTrack's NEMSIS importer will reject the XML document and give the reason why; you can over-ride this, and force the import as a cancellation, by enabling the relevant import option.

      Automatic Creation of Facility Records During Import

      AngelTrack can automatically create the necessary facility records during import of a NEMSIS document, where possible. This option is always enabled for any import received by the CAD API; it is a selectable option during manual imports.

      Facility records are keyed by the jurisdiction state and the state-issued facility codes, therefore AngelTrack can auto-create them only when the imported NEMSIS XML document provides all of the following information:

      • State facility code; cannot be a state-issued generic facility code such as "999999 = Other hospital"
      • Facility name
      • Facility street address
      • Facility state

      Attached PCR Documents

      AngelTrack will import electronic documents attached to the PCR, from the /eOther node.

      The NEMSIS XML specification allows only rudimentary identification of attached documents, so AngelTrack must guess the type of each attached document. For example, a face sheet might be marked as 4509003 "Billing Information", or it might be 4509017 "Patient Identification", or it might be 4509013 "Other Healthcare Record". AngelTrack will examine the filename for clues, but this is not reliable. As a result, your imported documents will often show an incorrect document type, which you might have to manually correct.

      AngelTrack does not import the following document types from NEMSIS XML:

      • 4509001 "Other Audio Recording"
      • 4509025 "Video/Movie"

      Delegations to Affiliates

      The NEMSIS XML importer does not support the import of trips delegated to an affiliate. Each trip's assigned vehicle and crew must be on file as your vehicle and your employees. As such, you cannot use this system to do the billing for a subcontracting provider.

      Attached Facility Records

      If the imported XML document specifies any state facility codes, AngelTrack will attempt to match them to its own facility records. This will work best if you have recently updated your AngelTrack server's facility list with the latest data from your state trauma registry; refer to the Facility List Importer Guide to learn how.

      AngelTrack cannot auto-generate any missing facility records, even though it has enough data to do so, because many states use generic facility codes that represent "Other destination" and therefore represents every unlisted street address. If AngelTrack were to auto-generate a facility record for one of these "Other destination" codes, then every future trip that references it would register at that street address.

      What Is and Is Not Imported

      Presently, AngelTrack imports the datafields and documents necessary for billing purposes. It does not import the entirety of the PCR data.

      To see which data nodes from the NEMSIS XML document are imported, please refer to the NEMSIS Import API Guide. We are constantly improving the importer, so the list is subject to change.

      As a result, imported calls cannot go through AngelTrack's QA Review system, nor can AngelTrack perform the necessary state trauma registry uploads. Those tasks must be performed by your PCR application.

      QA Review

      You cannot import NEMSIS trip XMLs into AngelTrack's QA review system. Instead they must bypass QA and go straight to billing.

      That means that QA review must be performed within your PCR application, before importing the charts into AngelTrack for billing.

      Import Option: Halt If No Crew Match

      The manual importer offers the option to ☑ Halt the import if the assigned vehicle and crew member(s) cannot be matched to our records. This option is enabled by default, because if you are importing a completed trip but AngelTrack can't match the vehicle callsign and/or crew patch number(s) to its own records then it has to mark the call as a cancellation.

      If an import fails for this reason, then review the error messages; they will tell you which vehicle callsign or crew patch number is missing from AngelTrack's records.

      Import Option: Postprocess Workflow Location

      By default, new trips are created at "Billing office" in the postprocess workflow. The importer's options give you the ability to instead start them at "Awaiting payment" or "Finished", as needed.

      Bill-To Settings Auto-Set During Import

      AngelTrack's NEMSIS importer will auto-set each new trip's bill-to settings, using information provided in the NEMSIS XML document, combined with the following information from your AngelTrack server:

      To learn which NEMSIS fields are used for this determination, please refer to the NEMSIS Import API Guide.

      Unfortunately, the billing-related fields in the NEMSIS XML schema do not fully cover the range of possibilities, so AngelTrack will not always be able to correctly guess the bill-to settings. Both the manual-import and the API-import processes will tell you what bill-to settings where auto-selected for each trip, so you can review it afterward and make any necessary adjustments.

      Nor does the NEMSIS XML schema provide a way to transmit price quotes or adjudicated prices, so every imported trip will begin un-priced, and later receive a price by means of AngelTrack's lazy price quoting.

      If you do any billing under a facility contract, then the accuracy of the automatic bill-to settings depends on correct match-up of your facility records with the facility IDs or names/addresses mentioned in each NEMSIS XML document. For that to work, both AngelTrack and your PCR application must have matching facility lists installed. That means both apps must be pre-configured with your state trauma registry's facility list and thereafter kept in sync as dispatchers, supervisors, and billers create new facility records in either system.

      Re-Import

      You can safely re-import an existing NEMSIS XML document without creating any accidental duplicates.

      A re-import might overwrite certain information added by a dispatcher, biller, or crew member after the initial import, so do not re-import trips unless you are certain it's necessary.

      The importer has an option to skip the import of any trip that was imported previously, and the option is enabled by default, to prevent accidental overwrites of data you modified since the initial import.

      Multi-Trip Imports

      If your NEMSIS XML document contains multiple trips, i.e. multiple /PatientCareReport nodes, AngelTrack's manual importer will import them all, and display the combined results in a list for review. Your XML document is nevertheless subject to AngelTrack's general file-upload limit, which is 16MB per file.

      This privilege is only available when performing manual imports of NEMSIS XML documents. For automatic imports, the NEMSIS Import API does not accept multi-trip submissions; your uploader tool must send each PCR's NEMSIS XML separately.

      Using AngelTrack's CAD and Billing System with Another PCR App

      By means of this system, you can use AngelTrack's CAD and its billing system while performing all charting in another PCR app.

      The PCR app must be able to import NEMSIS XML documents exported by AngelTrack's CAD, or else there must already be an integration in place by which AngelTrack's CAD can push trip data into the PCR. Here are some of AngelTrack's current integrations suitable for this purpose:

      When the PCR app finishes each trip, it must push or otherwise export the completed NEMSIS XMLs for re-import back into AngelTrack. When that happens, AngelTrack will recognize its own trips and automatically match them back up to the records from the CAD. For this to work right, the PCR app must:

      1. Accept imports in NEMSIS v3.5.0, or accepts some other data format that includes the @UUID attribute provided by AngelTrack's CAD; and
      2. Return the same @UUID attribute back to AngelTrack during re-import of the completed chart.