Appendix C 04/28/16 Tamara SYSTEM GENERATED Removed “Sample: Manuel REPORTS - Subsection: REF*ZZ*0101C~” Information. 820 File (FI to PIHP) Tamara Table of Footer Corrected Month of the Footer 05/25/16 Manuel Contents Information to May 2016 Version 3. Tamara Section 13 PMPM Payment Removed verbiage 05/25/16 “Effective Manuel Recovery for Duplicate May from 1st paragraph. 2016” Recipient Medicaid IDs (Magellan) Tamara Table of Title Page & Footer of Corrected Month of the Footer 06/02/16 Manuel Contents Document Information to June 2016 Version 4. Tamara Appendix P PIHP CSoC Batch Updated highlighted text 06/03/16 Manuel Electronic File Layout language in yellow. & 6/10/16 for TPL Information Appendix P 06/03/16 Tamara PIHP CSoC Batch Added the TPL Scope of Manuel Electronic File Layout Coverage and the TPL Initiator for TPL Information Codes Tables. Tamara Title Page LDH Logo Added new Logo for LDH 06/08/16 – Manuel Louisiana Department of Health. Tamara Appendix P PIHP CSoC Batch Added the TPL Carrier Code File 06/09/16 Manuel Electronic File Layout Layout Table. for TPL Information Tamara Entire PIHP CSoC System Replaced DHH with LDH and 06/09/16 Manuel Document Companion Guide Louisiana Dept. of Health and Hospitals with Louisiana Department of Health throughout the entire document. Tamara Table of Title Page & Footer of Corrected Month of the Footer 07/11/16 Manuel Contents Document Information to July 2016 Version 5. Appendix P 07/20/16 Tamara PIHP CSoC Batch Removed highlighted from text Manuel Electronic File Layout language. for TPL Information Tamara Section 2 Batch Submissions Added The EDI Transmission 07/20/16 Manuel Research Request Instructions and Form Tamara Table of Reformatted/Page Reformatted entire document for 07/20/16 Manuel Contents Numbering automatic processing of all type through of headings and page numbering. Appendix R
Tamara Manuel Appendix C SYSTEM GENERATED REPORTS - Subsection: 820 File (FI to PIHP) Removed “Sample: REF*ZZ*0101C~” Information. 04/28/16 Tamara Manuel Table of Contents Footer Corrected Month of the Footer Information to May 2016 Version 3. 05/25/16 Tamara Manuel Section 13 PMPM Payment Recovery for Duplicate Recipient Medicaid IDs (Magellan) Removed verbiage “Effective May 2016” from 1st paragraph. 05/25/16 Tamara Manuel Table of Contents Title Page & Footer of Document Corrected Month of the Footer Information to June 2016 Version 4. 06/02/16 Tamara Manuel Appendix P PIHP CSoC Batch Electronic File Layout for TPL Information Updated highlighted text language in yellow. 06/03/16 & 6/10/16 Tamara Manuel Appendix P PIHP CSoC Batch Electronic File Layout for TPL Information Added the TPL Scope of Coverage and the TPL Initiator Codes Tables. 06/03/16 Tamara Manuel Title Page LDH Logo Added new Logo for LDH – Louisiana Department of Health. 06/08/16 Tamara Manuel Appendix P PIHP CSoC Batch Electronic File Layout for TPL Information Added the TPL Carrier Code File Layout Table. 06/09/16 Tamara Manuel Entire Document PIHP CSoC System Companion Guide Replaced DHH with LDH and Louisiana Dept. of Health and Hospitals with Louisiana Department of Health throughout the entire document. 06/09/16 Tamara Manuel Table of Contents Title Page & Footer of Document Corrected Month of the Footer Information to July 2016 Version 5. 07/11/16 Tamara Manuel Appendix P PIHP CSoC Batch Electronic File Layout for TPL Information Removed highlighted from text language. 07/20/16 Tamara Manuel Section 2 Batch Submissions Added The EDI Transmission Research Request Instructions and Form 07/20/16 Tamara Manuel Table of Contents through Appendix R Reformatted/Page Numbering Reformatted entire document for automatic processing of all type of headings and page numbering. 07/20/16