Report the that describes the member's / subscriber's enrollment into one of the Lookup Member APCD ID predefined categories; aligns enrollment to DC 68 11/8/12 Table - int[1] Enrollment All 100% A2 Code appropriate editing and thresholds. Integer Type EXAMPLE: 1 = FIG - Fully Insured Commercial Group Enrollee. Value Description FIG - Fully-Insured Commercial Group 1 Enrollee 2 SIG - Self-Insured Group Enrollee GIC - Group Insurance Commission 3 Enrollee MCO - MassHealth Managed Care 4 Organization Enrollee 5 Supplemental Policy Enrollee 6 ICO - Integrated Care Organization 0 Unknown / Not Applicable Report DC here. This validates the type of Record File Type DC 69 11/8/12 Text ID File char[2] file and the data contained within the file. All 100% A0 Type Identifier This must match HD004 TR Record Trailer Record Report here. Indicates the end of the 1 6/24/10 Text ID Record char[2] Mandatory 100% TM Type Identifier data file Trailer Submitter / Report the Unique Submitter ID as defined 2 Submitter 11/8/12 Integer ID Submitter varchar[6] Carrier ID by CHIA here. This must match the Mandatory 100% TM defined by Submitter ID reported in HD002 CHIA CMS National Do not report any value here until National Plan PlanID is fully implemented. This is a National 3 11/8/12 Integer ID Nat'l PlanID int[10] Identification unique identifier as outlined by Centers for Situational 0% TS Plan ID Number Medicare and Medicaid Services (CMS) for (PlanID) Plans or Sub plans
DC 68 APCD ID Code 11/8/12 Lookup Table - Integer int[1] Member Enrollment Type Report the that describes the member's / subscriber's enrollment into one of the predefined categories; aligns enrollment to appropriate editing and thresholds. EXAMPLE: 1 = FIG - Fully Insured Commercial Group Enrollee. All 100% A2 Value Description 1 FIG - Fully-Insured Commercial Group Enrollee 2 SIG - Self-Insured Group Enrollee 3 GIC - Group Insurance Commission Enrollee 4 MCO - MassHealth Managed Care Organization Enrollee 5 Supplemental Policy Enrollee 6 ICO - Integrated Care Organization 0 Unknown / Not Applicable DC 69 Record Type 11/8/12 Text ID File char[2] File Type Identifier Report DC here. This validates the type of file and the data contained within the file. This must match HD004 All 100% A0 1 Record Type 6/24/10 Text ID Record char[2] Trailer Record Identifier Report TR here. Indicates the end of the data file Mandatory 100% TM 2 Submitter 11/8/12 Integer ID Submitter varchar[6] Trailer Submitter / Carrier ID defined by CHIA Report the Unique Submitter ID as defined by CHIA here. This must match the Submitter ID reported in HD002 Mandatory 100% TM 3 National Plan ID 11/8/12 Integer ID Nat'l PlanID int[10] CMS National Plan Identification Number (PlanID) Do not report any value here until National PlanID is fully implemented. This is a unique identifier as outlined by Centers for Medicare and Medicaid Services (CMS) for Plans or Sub plans Situational 0% TS
v3-1-apcd-dental-claim-file-submission-guide-2013-06.docx