Report the Subscriber's SSN here; Subscriber's used to validate Unique Member ID; Subscriber MC 8 11/8/12 Numeric ID Tax char[9] Social Security will not be passed into analytic file. All 79% B 07 SSN Number Do not use hyphen. If not available do not report any value here Report the Plan assigned contract number. Do not include values in Plan this field that will distinguish one Specific MC 6/24/10 Text ID Contract Contract Number member of the family from another. All 98% C 08 Contract This should be the contract or Number certificate number for the subscriber and all of the dependents. Member Member/Patient's Report the unique number / identifier Suffix or Contract MC 10 6/24/10 Text ID Sequence of the member / patient within the All 98% B Sequence Sequence contract. Number Number Report the patient's social security number here; used to validate Member/Patient's Member Unique Member ID; will not be MC 11 11/8/12 Numeric ID Tax char[9] Social Security All 73% B SSN passed into analytic file. Do not use Number hyphen. If not available do not report any value here. Report the that defines the Individual Lookup Patient to Patient's relationship to the MC 12 6/24/10 Table char[2] Subscriber All 98% B Subscriber. EXAMPLE: 20 = Self / Code Text Relationship Code Employee Value Description 01 Spouse Grandfather or Grandmother 05 Grandson or Granddaughter Nephew or 10 Foster Child 15 Ward 17 Stepson or Stepdaughter 19 Child
MC 8 Subscriber SSN 11/8/12 Numeric ID Tax char[9] Subscriber's Social Security Number Report the Subscriber's SSN here; used to validate Unique Member ID; will not be passed into analytic file. Do not use hyphen. If not available do not report any value here All 79% B MC Plan Specific Contract Number 6/24/10 Text ID Contract Contract Number Report the Plan assigned contract number. Do not include values in this field that will distinguish one member of the family from another. This should be the contract or certificate number for the subscriber and all of the dependents. All 98% C MC 10 Member Suffix or Sequence Number 6/24/10 Text ID Sequence Member/Patient's Contract Sequence Number Report the unique number / identifier of the member / patient within the contract. All 98% B MC 11 Member SSN 11/8/12 Numeric ID Tax char[9] Member/Patient's Social Security Number Report the patient's social security number here; used to validate Unique Member ID; will not be passed into analytic file. Do not use hyphen. If not available do not report any value here. All 73% B MC 12 Individual Code 6/24/10 Lookup Table Text char[2] Patient to Subscriber Relationship Code Report the that defines the Patient's relationship to the Subscriber. EXAMPLE: 20 = Self / Employee All 98% B Value Description 01 Spouse Grandfather or Grandmother 05 Grandson or Granddaughter 07 Nephew or 10 Foster Child 15 Ward 17 Stepson or Stepdaughter 19 Child 08
v3-1-apcd-medical-claim-file-submission-guide-2013-06.docx