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Source Company

16, Maryland

Versions: February 20, 2013• September 13, 2013• January 9, 2014Compare Versions


Name:Source Company
Data Element ID:16
Description:Defines the payer company that holds the beneficiary's contract; for use in characterizing contract requirements under Maryland law.
State:Maryland
Data Type:alphanumeric
Length:1
Threshold:99%
Start:52
End:52
COMAR:10.25.06.10 C.(14)
Field Contents:renamed from Delivery System Type
Permissible Values: Source Company uses the following permissible values:
Code / Value Meaning
1 Health Maintenance Organization
2 Life & Health Insurance Company or Not-for-Profit Health Benefit Plan
3 Third-Party Administrator (TPA) Unit
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File Specification for Multiple versionsMedical Eligibility File Submission - February 20, 2013

Data Element ID Data Element Description Type Format Length
Multiple versions1 Record Identifier The value is 5 numeric 1
Multiple versions2 Encrypted Enrollee IdentifierP (payer encrypted) Enrollee's unique identification number assigned by payer and encrypted. alphanumeric 12
Multiple versions3 Encrypted Enrollee IdentifierU (UUID encrypted) Enrollee's universally unique identification (UUID) number generated using an encryption algorithm provided by MHCC. alphanumeric 12
Multiple versions4 Enrollee Year and Month of Birth Date of enrollee's birth using 00 instead of day. numeric CCYYMM00 8
Multiple versions5 Enrollee Sex Sex of the enrollee. numeric 1
Multiple versions6 Enrollee Zip Code of Residence Zip code of enrollee's residence. numeric 5
Multiple versions7 Enrollee County of Residence County of enrollee's residence. If known, please provide. If not known, MHCC will arbitrarily assign using Zip code of residence. numeric 3
Multiple versions8 Source of Enrollee Race/Ethnicity Information Race/ethnicity of enrollee gathered from enrollee or other source. numeric 1
Multiple versions9 Enrollee OMB Race 1 Race of enrollee. numeric 1
Multiple versions10 Enrollee OMB Race 2 Race of enrollee. numeric 1
Multiple versions11 Enrollee OMB Race 3 Not provided numeric 1
Multiple versions12 Enrollee OMB Hispanic Ethnicity 1 (Hispanic Indicator) Ethnicity of enrollee. numeric 1
Multiple versions13 Enrollee Other Ethnicity 2 Not provided numeric 1
Multiple versions14 Enrollee Preferred Spoken Language A locally relevant list of languages will be developed by the Commission in consort with the Racial, Ethnic and Language Disparities Work Group. numeric 2
Multiple versions15 Coverage Type Enrollee's type of insurance coverage. alphanumeric 1
Multiple versions16 Source Company Defines the payer company that holds the beneficiary's contract; for use in characterizing contract requirements under Maryland law. alphanumeric 1
Multiple versions17 Product Type Classifies the benefit plan by key product characteristics (scope of coverage, size of network, coverage for out-of-network benefits). (Please code based on how the product is primarily marketed, and most importantly be consistent from year to year. If not sure, send an e-mail describing the product to Larry Monroe at larry.monroe@maryland.gov) numeric 1
Multiple versions18 Policy Type Type of policy. numeric 1
Multiple versions19 Encrypted Contract or Group Number Payer assigned contract or group number for the plan sponsor using an encryption algorithm generated by the payer. alphanumeric 20
Multiple versions20 Employer Federal Tax ID Number Employer Federal Tax ID number will be encrypted by the database contractor in such a way that an employer will have the same encrypted ID across all payer records and the same employer has the same encrypted number from year to year. alphanumeric 9
Multiple versions21 Medical Services Indicator Medical Coverage numeric 1
Multiple versions22 Pharmacy Services Indicator Prescription Drug Coverage numeric 1
Multiple versions23 Behavioral Health Services Indicator Behavioral Health Services Coverage numeric 1
Multiple versions24 Dental Services Indicator Dental Coverage numeric 1
Multiple versions25 Plan Liability Indicates if insurer is at risk for the patient's service use or the insurer is simply paying claims as an ASO. numeric 1
Multiple versions26 Consumer Directed Health Plan (CDHP) with HSA or HRA Indicator Consumer Directed Health Plan (CDHP) with Health Savings Account (HSA) or Health Resources Account (HRA). numeric 1
Multiple versions27 Start Date of Coverage The start date for benefits in the month (for example, if the enrollee was insured at the start of the month of January in 2012, the start date is 20120101) numeric CCYYMMDD 8
Multiple versions28 End Date of Coverage The end date for benefits in the month (for example, if the enrollee was insured for the entire month of January in 2012, the end date is 20120131) numeric CCYYMMDD 8
Multiple versions29 Date of FIRST Enrollment The date of that the patient was initially enrolled with your organization. numeric CCYYMMDD 8
Multiple versions30 Date of Disenrollment The end date of enrollment for the patient in this delivery system (in this data submission time period). numeric CCYYMMDD 8
Multiple versions31 Relationship to Policyholder Member's relationship to subscriber/insured. numeric 1
Multiple versions32 Payer ID Number Payer assigned submission identification number. alphanumeric 4
Multiple versions33 Source System Identify the source system (platforms or business units) from which the data was obtained by using an alphabet letter (A, B, C, D, etc...) For payers with all data coming from one system only, leave the field blank. alphanumeric 1

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