United States Health Information Knowledgebase

 

Market Category

ME030, New Hampshire



Name:Market Category
Data Element ID:ME030
Description:Not provided
State:New Hampshire
Data Type:Text
Length:4
HIPAA Reference Transaction Set/Loop/Segment/Qualifier/Data Element:N/A
Permissible Values: Market Category uses the following permissible values:
Code / Value Meaning
FCH for policies sold and issued directly to individuals on a franchise basis as defined pursuant to RSA 415:19
GCV for policies sold and issued directly to individuals as group conversion policies as required pursuant to RSA 415:18 VII (a)
GLG1 for policies sold and issued directly to employers having between 51 and 99 employees
GLG2 for policies sold and issued directly to employers having 100 or more employees
GS1 for policies sold and issued directly to employers having exactly one employee
GS2 for policies sold and issued directly to employers having between 2 and 9 employees
GS3 for policies sold and issued directly to employers having between 10 and 25 employees
GS4 for policies sold and issued directly to employers having between 26 and 50 employees
GSA for policies sold and issued directly to small employers through a qualified association trust
IND for policies sold and issued directly to individuals, other than those sold on a franchise basis, as defined pursuant to RSA 415:19, or as group conversion policies as defined pursuant to RSA 415:18 VII (a)
OTH for policies sold to other types of entities. Carriers using this market code shall obtain prior approval from the NH Insurance Department
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File Specification for Medical Eligibility File Submission - September 10, 2012

Data Element ID Data Element Description Type Format Length
HD001 Record Type Not provided Text 2
HD002 Payer Payer submitting payments NHID Submitter Code Text 8
HD003 National Plan ID CMS National Plan ID Text 30
HD004 Type of File Not provided Text 2
HD005 Period Beginning Date Beginning of paid period for claims Beginning of month covered for eligibility Integer CCYYMM 6
HD006 Period Ending Date End of paid period for claims End of month covered for eligibility Integer CCYYMM 6
HD007 Record Count Total number of records submitted in this file Integer 10
HD008 Comments Submitted may use to document this submission by assigning a filename, system source, etc. Text 80
ME001 Payer Payer submitting payments NHID Submitter Code Text 8
ME002 National Plan ID CMS National Plan ID Text 30
ME003 Insurance Type Code/Product Not provided Text 2
ME004 Year Year for which eligibility is reported in this submission Integer 4
ME005 Month Month for which eligibility is reported in this submission Integer 2
ME006 Insured Group or Policy Number Group or policy number (not the number that uniquely identifies the subscriber) Text 50
ME007 Coverage Level Code Benefit Coverage Level Text 3
ME008 Subscriber Social Security Number Subscriber's social security number (set as null if unavailable) (this data element will be de-identified by the NHpreprocessor application) Text 128
ME009 Plan Specific Contract Number Plan assigned contract number (set as null if contract number = subscriber's social security number) (this data element will be de-identified by the NHpreprocessor application) Text 128
ME010 Member Suffice or Sequence Number Uniquely numbers the member within the contract Integer 2
ME011 Member Identification Code Member's social security number (set as null if unavailable) (this data element will be de-identified by the NHpreprocessor application) Text 128
ME012 Individual Relationship Code Member's relationship to insured Integer 2
ME013 Member Gender Not provided Text 1
ME014 Member Date of Birth Not provided Date CCYYMMDD 8
ME015 Member City Name City name of member Text 30
ME016 Member State or Province As defined by the US Postal Service Text 2
ME017 Member ZIP Code ZIP Code of member - may include non-US codes. (Do not include dash) Text 11
ME018 Medical Coverage Not provided Text 1
ME019 Prescription Drug Coverage Not provided Text 1
ME020 Dental Coverage Not provided Text 1
ME021 Race 1 Not provided Text 6
ME022 Race 2 Not provided Text 6
ME023 Placeholder Not provided Not Supplied Not Supplied Not Supplied
ME024 Hispanic Indicator Not provided Text 1
ME025 Ethnicity 1 Not provided Text 6
ME026 Ethnicity 2 Not provided Text 6
ME027 Place holder Not provided 20
ME028 Primary Insurance Indicator Not provided Text 1
ME029 Coverage Type Not provided Text 3
ME030 Market Category Not provided Text 4
ME031 Special Coverage Not provided Text 3
ME032 Group Name Name of the group which the member is covered by. If the member is part of a group of one or non-group then this field shall be set as null Text 128
ME101 Subscriber Last Name (this data element will be de-identified by the NHpreprocessor application) Not provided Text 128
ME102 Subscriber First Name (this data element will be de-identified by the NHpreprocessor application) Not provided Text 128
ME103 Subscriber Middle Initial (this data element will be de- identified by the NHpreprocessor application) Not provided Text 1
ME104 Member Last Name (this data element will be de-identified by the NHpreprocessor application) Not provided Text 128
ME105 Member First Name (this data element will be de-identified by the NHpreprocessor application) Not provided Text 128
ME106 Member Middle Initial (this data element will be de-identified by the NHpreprocessor application) Not provided Text 1
ME899 Record Type Not provided Text 2
TR001 Record Type Not provided Text 2
TR002 Payer Payer submitting payments NHID Submitter Code Text 8
TR003 National Plan ID CMS National Plan ID Text 30
TR004 Type of File Not provided Text 2
TR005 Period Beginning Date Beginning of paid period for claims Beginning of month covered for eligibility Integer CCYYMM 6
TR006 Period Ending Date End of paid period for claims End of month covered for eligibility Integer CCYYMM 6
TR007 Date Processed Not provided Date CCYYMMDD 8

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