Report the Practice Group OrgID number as assigned / maintained by CHIA for Total Medical Expense (TME) reporting Data must be reported in aggregate for all practices in which the Local Practice Group’s member months Required are below 36,000 and the when Provider CHIA defined and practice has no parent submitter is PV 31 11/8/12 Integer ID OrgID varchar[6] maintained Org ID Physicians’ Group. This identified 100% A2 ID for Providers group is to be identified as as a below minimum TME/RP “Groups threshold” with an ORGID Submitter of 999996. For Local Practice Groups below the 36,000 member month threshold that are part of a larger Physicians’ Group, payers will report the ORGID of the Parent Physician Group. Report the Health Policy Commission-assigned unique Registered Health Policy identifier for every service provider Assigned Provider Commission Registered Provider (persons, facilities or other entities PV 32 4/5/13 Text Char[30] submitters 0% Z OrgID Organization ID involved in claims transactions) that only ID (RPO) Placeholder it has in its system(s). This information is required for TME/RP reporting and analysis. The APCD reserves this element for PV 33 Filler 11/8/12 Filler Filler char[0] Filler future use. Do not populate with any All 0% Z data. Report the value that defines type of entity associated with PV002. The Lookup Provider ID Provider value reported here drives intake PV 34 11/8/12 - int[1] All 100% A0 Code Identification Code edits for quality purposes. Integer EXAMPLE: 1 = Person; Physician, Clinician, Orthodontist, etc.
PV 31 Provider ID 11/8/12 Integer ID OrgID varchar[6] CHIA defined and maintained Org ID for Providers Report the Practice Group OrgID number as assigned / maintained by CHIA for Total Medical Expense (TME) reporting Data must be reported in aggregate for all practices in which the Local Practice Group’s member months are below 36,000 and the practice has no parent Physicians’ Group. This group is to be identified as “Groups below minimum threshold” with an ORGID of 999996. For Local Practice Groups below the 36,000 member month threshold that are part of a larger Physicians’ Group, payers will report the ORGID of the Parent Physician Group. Required when submitter is identified as a TME/RP Submitter 100% A2 PV 32 Registered Provider ID (RPO) 4/5/13 Text Health Policy Commission OrgID Placeholder Char[30] Registered Provider Organization ID Report the Health Policy Commission-assigned unique identifier for every service provider (persons, facilities or other entities involved in claims transactions) that it has in its system(s). This information is required for TME/RP reporting and analysis. Assigned submitters only 0% Z PV 33 Filler 11/8/12 Filler Filler char[0] Filler The APCD reserves this element for future use. Do not populate with any data. All 0% Z PV 34 Provider ID Code 11/8/12 Lookup - Integer int[1] Provider Identification Code Report the value that defines type of entity associated with PV002. The value reported here drives intake edits for quality purposes. EXAMPLE: 1 = Person; Physician, Clinician, Orthodontist, etc. All 100% A0
apcd-provider-file-submission-guide.docx