Thank you for your partnership with CHIA on the all payer claims database. 957 CMR 8.00: APCD and Case Mix Data Submission administrative simplification state entities in Massachusetts. No public disclosure of any health plan information or data shall be made unless specifically authorized under 957 CMR 5.00. Acronyms Frequently Used APCD Claims Database – CHIA Center for Health Information and Analysis – CSO Computer Services Organization – DBA Delegated Benefit Administrator – DBM Dental Benefit Manager – DOI Division of Insurance – GIC Insurance Commission – ID Identification; Identifier – MA APCD Massachusetts’ All-Payer Claims Database – NPI National Provider Identifier – PBM Pharmacy Benefit Manager – QA Quality Assurance – RA Risk Adjustment; Risk Adjuster – TME / RP Total Medical Expense / Relative Pricing – TPA Party Administrator – The File Types: DC Dental Claims – MC Medical Claims – ME Member Eligibility –
Thank you for your partnership with CHIA on the all payer claims database. 957 CMR 8.00: APCD and Case Mix Data Submission administrative simplification state entities in Massachusetts. No public disclosure of any health plan information or data shall be made unless specifically authorized under 957 CMR 5.00. Acronyms Frequently Used APCD – Claims Database CHIA – Center for Health Information and Analysis CSO – Computer Services Organization DBA – Delegated Benefit Administrator DBM – Dental Benefit Manager DOI – Division of Insurance GIC – Insurance Commission ID – Identification; Identifier MA APCD – Massachusetts’ All-Payer Claims Database NPI – National Provider Identifier PBM – Pharmacy Benefit Manager QA – Quality Assurance RA – Risk Adjustment; Risk Adjuster TME / RP – Total Medical Expense / Relative Pricing TPA – Party Administrator The File Types: DC – Dental Claims MC – Medical Claims ME – Member Eligibility
v6-apcd-pharmacy-claim-file-submission-guide-Redline-.docx