Appendix E PIHP Generated Reports Changed Appendix letter to 11/18/15 Tamara “D” Manuel Tamara Appendix F Encounter Edit Codes Changed Appendix letter to 11/18/15 “E” Manuel Tamara Appendix G Provider Changed Appendix letter to 11/18/15 “F” Manuel Directory/Network Provider and Sub Registry Tamara Appendix H Test Plan Changed Appendix letter to 11/18/15 “G” Manuel Tamara Appendix I Websites Changed Appendix letter to 11/18/15 “H” Manuel Tamara Appendix J LTC CSoC PIHP Changed Appendix letter to 11/18/15 “I” Manuel Segment Layout Appendix K Prior Authorization File Changed Appendix letter to 11/18/15 Tamara “J” Manuel Tamara Appendix L Provider Type Provider Changed Appendix letter to 11/18/15 – “K” Manuel Specialty Taxonomy – Crosswalk Andrea Appendix M Supplemental Claims Highlighted fields are the items 11/2/15 Hollins History File Layout used to identify BH services. TM TM – Tamara Changed Appendix letter to 11/18/15 – “L” Manuel Tamara Appendix N Provider Supplemental Added the Provider Supplemental 11/4/15 Manuel Record Layout Record Layout TM – 11/18/15 Changed Appendix letter to “M” Tamara Appendix N CSoC Chisholm Added CSoC Chisholm 11/18/15 Manuel Electronic File Layout Electronic File Layout Andrea Appendix O Master File Exchange Added Inbound/Outbound File 11/2/15 Hollins/ Schedule Schedule TM - Tamara Changed Appendix letter from N 11/18/15 Manuel to Updated schedules with “O”. new Inbound/Outbound files with naming conventions noted in yellow highlight. Tamara December See Updates Below starting with 11/23/15 Manuel 2015 - date 11/23/2015 Version 2.1 Tamara Section 3 Encounter Edit Codes Deleted Edit Codes that were 11/23/15 Manuel designated to be turned off or and educational. Off 001,004,012, 12/06/15 – 013,018, 019, 031, 065, 088,
Tamara Manuel Appendix E PIHP Generated Reports Changed Appendix letter to “D” 11/18/15 Tamara Manuel Appendix F Encounter Edit Codes Changed Appendix letter to “E” 11/18/15 Tamara Manuel Appendix G Provider Directory/Network Provider and Sub Registry Changed Appendix letter to “F” 11/18/15 Tamara Manuel Appendix H Test Plan Changed Appendix letter to “G” 11/18/15 Tamara Manuel Appendix I Websites Changed Appendix letter to “H” 11/18/15 Tamara Manuel Appendix J LTC CSoC PIHP Segment Layout Changed Appendix letter to “I” 11/18/15 Tamara Manuel Appendix K Prior Authorization File Changed Appendix letter to “J” 11/18/15 Tamara Manuel Appendix L Provider Type – Provider Specialty – Taxonomy Crosswalk Changed Appendix letter to “K” 11/18/15 Andrea Hollins Tamara Manuel Appendix M Supplemental Claims History File Layout Highlighted fields are the items used to identify BH services. TM – Changed Appendix letter to “L” 11/2/15 TM – 11/18/15 Tamara Manuel Appendix N Provider Supplemental Record Layout Added the Provider Supplemental Record Layout Changed Appendix letter to “M” 11/4/15 TM – 11/18/15 Tamara Manuel Appendix N CSoC Chisholm Electronic File Layout Added CSoC Chisholm Electronic File Layout 11/18/15 Andrea Hollins/ Tamara Manuel Appendix O Master File Exchange Schedule Added Inbound/Outbound File Schedule Changed Appendix letter from N to “O”. Updated schedules with new Inbound/Outbound files with naming conventions noted in yellow highlight. 11/2/15 TM - 11/18/15 Tamara Manuel December 2015 - Version 2.1 See Updates Below starting with date 11/23/2015 11/23/15 Tamara Manuel Section 3 Encounter Edit Codes Deleted Edit Codes that were designated to be turned off or educational. Off – 001,004,012, 013,018, 019, 031, 065, 088, 11/23/15 and 12/06/15
PIHP_CSoC_SystemsCompanionGuide-Sept2018_V12.docx