FIG - Fully-Insured Commercial 1 Group Enrollee 2 SIG - Self-Insured Group Enrollee GIC - Insurance Commission 3 Enrollee MCO - MassHealth Managed 4 Care Organization Enrollee 5 Supplemental Policy Enrollee ICO - Integrated Care 6 Organization 0 Unknown / Not Applicable Report MC here. This validates the Record type of file and the data contained MC 6/24/10 Text ID File char[2] File Type Identifier All 100% A0 Type within the file. This must match HD004 . Record Trailer Record Report TR here. Indicates the end of 1 6/24/10 Text ID Record char[2] Mandatory 100% TM Type Identifier the data file. Report the Unique Submitter ID as Trailer Submitter / defined by CHIA here. This must 2 Submitter 11/8/12 Integer ID Submitter varchar[6] Carrier ID defined Mandatory 100% TM match the Submitter ID reported in by CHIA HD002. Do not report any here until National PlanID is fully implemented. CMS National National This is a unique identifier as outlined 3 11/8/12 Integer ID Nat'l PlanID int[10] Plan Identification Situational 0% TS Plan ID by Centers for Medicare and Number (PlanID) Medicaid Services (CMS) for Plans or Sub plans. Validates the file Type of Report MC here. This must the 4 6/24/10 Text ID File char[2] type defined in Mandatory 100% TM File File Type reported in HD004. HD004. Report the Year and Month of the Period Date Century Year reported submission period in Trailer Period 5 Beginning 6/24/10 Period - Month - int[6] CCYYMM format. This date period Mandatory 100% TM Start Date Date Integer CCYYMM must match the date period reported in HD005 and HD006.
1 FIG - Fully-Insured Commercial Group Enrollee 2 SIG - Self-Insured Group Enrollee 3 GIC - Insurance Commission Enrollee 4 MCO - MassHealth Managed Care Organization Enrollee 5 Supplemental Policy Enrollee 6 ICO - Integrated Care Organization 0 Unknown / Not Applicable MC Record Type 6/24/10 Text ID File char[2] File Type Identifier Report MC 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 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 4 Type of File 6/24/10 Text ID File char[2] Validates the file type defined in HD004. Report MC here. This must the File Type reported in HD004. Mandatory 100% TM 5 Period Beginning Date 6/24/10 Date Period - Integer Century Year Month - CCYYMM int[6] Trailer Period Start Date Report the Year and Month of the reported submission period in CCYYMM format. This date period must match the date period reported in HD005 and HD006. Mandatory 100% TM
v3-1-apcd-medical-claim-file-submission-guide-2013-06.docx