Appendix G: Source of Payment Crosswalk

Source of Payment codes are utilized by the Arkansas Department of Health hospital inpatient discharge data and emergency department data. Processing systems changed between 2014 and 2015, resulting in new values and consolidated definitions.

This table provides a crosswalk of the available values and associated definitions by year. For example, 2013-14 data for Champus would contain the value C in the source of payment fields. 2015 and later data would use the value 3.

Value	Description	Value	Description
Years through 2014		Years 2015 forward
A	Self Pay (Indicates uninsured)	8	No Payment from an Organization/Agency/Program/Private Payer Listed (Self-pay, No charge, Refusal to Pay/Bad Debit, Hill Burton Free Care, Research/Donor, No Payment - Other) (Indicates uninsured)
B	Blue Cross/Blue Sheild, Medi-Pak, Medi-Pak Plus	6	Blue Cross/Blue Shield (BC Indemnity, BC Managed Care, BC Out of State, BC Unspecified, BC Other)
C	Champus	3	Other Government = Federal/State/Local (Includes Departments of Defense & Veterans Affairs, Indian Health Service or Tribe, HRSA Program, Black Lung, State Government, Other Government & Other Federal)
D	Medicaid	2	Medicaid (Medicaid Managed Care, Non Managed Care Plan, SCHIP, Applicant, Out of State and Other)
E	County or State (ex:state or county employees)	3	Other Government = Federal/State/Local (Includes Departments of Defense & Veterans Affairs, Indian Health Service or Tribe, HRSA Program, Black Lung, State Government, Other Government & Other Federal)
F	Commercial Insurance	5	Private Health Insurance (Private Managed Care, Private Health Insurance - Indemnity, Other non-specified Private Managed Care or Private Health Insurance - Indemnity, Organized Delivery System, Small Employer Purchasing Group, Other Private Insurance)
G	Blue Cross/Blue Shield, Medi-Pak, Medi-Pak Plus	6	Blue Cross/Blue Shield (BC Indemnity, BC Managed Care, BC Out of State, BC Unspecified, BC Other)
H	HMO/Managed Care	7	Managed Care, Unspecified (HMO, PPO, POS, Other Managed Care - Unknown if public or private)
I	Commercial Insurance	5	Private Health Insurance (Private Managed Care, Private Health Insurance - Indemnity, Other non-specified Private Managed Care or Private Health Insurance - Indemnity, Organized Delivery System, Small Employer Purchasing Group, Other Private Insurance)
J	County or State (ex:state or county employees)	4	Departments of Corrections (Includes federal, state, and local)
K	County or State (ex:state or county employees)	3	Other Government = Federal/State/Local (includes Departments of Defense & Veterans Affairs, Indian Health Service or Tribe, HRSA Program, Black Lung, State Government, Other Government & Other Federal)
L	Managed Assistance	7	Managed Care, Unspecified (HMO, PPO, POS, Other Managed Care - Unknown if public or private)
M	Medicare	1	Medicare (includes Medicare Managed, Non-Managed Care & Other)
N	Division of Health Services	3	Other Government = Federal/State/Local (Includes Departments of Defense & Veterans Affairs, Indian Health Service or Tribe, HRSA Program, Black Lung, State Government, Other Government & Other Federal)
O	Other	9	Miscellaneous/Other (Foreign National, Other (non-government), Disability Insurance, Long-term Care Insurance, Worker's Compensation, Auto Insurance (no fault), Other specified (includes Hospice), NoTypology Code available for payment source)
P	Self Pay (Indicates uninsured)	8	No Payment from an Organization/Agency/Program/Private Payer Listed (Self-pay, No charge, Refusal to Pay/Bad Debit, Hill Burton Free Care, Research/Donor, No Payment - Other)
Q	HMO/Managed Care	7	Managed Care, Unspecified (HMO, PPO, POS, Other Managed Care - Unknown if public or private)
S	Self Insured	5	Private Health Insurance (Private Managed Care, Private Health Insurance - Indemnity, Other non-specified Private Managed Care or Private Health Insurance - Indemnity, Organized Delivery System, Small Employer Purchasing Group, Other Private Insurance)
V	Other Federal Programs	3	Other Government = Federal/State/Local (Includes Departments of Defense & Veterans Affairs, Indian Health Service or Tribe, HRSA Program, Black Lung, State Government, Other Government & Other Federal)
W	Workman's Compensation	9	Miscellaneous/Other (Foreign National, Other (non-government), Disability Insurance, Long-term Care Insurance, Worker's Compensation, Auto Insurance (no fault), Other specified (includes Hospice), NoTypology Code available for payment source)
Z	Medically Indigent/Free (Indicates uninsured)	8	No Payment from an Organization/Agency/Program/Private Payer Listed (Self-pay, No charge, Refusal to Pay/Bad Debit, Hill Burton Free Care, Research/Donor, No Payment - Other)