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Payer

HD002, Vermont



Name:Payer
Data Element ID:HD002
Description:Payer submitting payments;
State:Vermont
Data Type:Text
Length:8
Column:2
Threshold:100%
Denominator:All
Encrypt:N
Database Fieldname:PAYER
File:HD
Required Start Date:1/31/2007
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File Specification for Medical Eligibility File Submission - October 2008

Data Element ID Data Element Description Type Format Length
HD001 Record Type HD Text 2
HD002 Payer Payer submitting payments; Text 8
HD003 National Plan Id CMS National Plan ID; This is not yet available. Code as null Text 30
HD004 Type of File ME 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 the file Integer 10
HD008 Comments Payer comments Text 80
ME001 Payer Payer submitting payments; Text 8
ME002 National Plan ID CMS National Plan ID; This is not yet available. Code as null Text 30
ME003 Insurance Type Code/Product Type of Insurance Product Text 2
ME004 Year Paid year of submission Integer 4
ME005 Month Paid month of submission Integer 2
ME006 Insured Group or Policy Number Group number or Policy Number Text 30
ME007 Coverage Level Code Level of coverage for the benefit Text 3
ME008 Encrypted Subscriber Unique Identification Number Subscriber's social security number; used to create unique member ID Text 128
ME009 Plan Specific Contract Number Do not include values in this field that will distinguish one member of the family from another. If submitted, this should be the contract or certificate number for the subscriber and all of his/her dependents Text 128
ME010 Member Suffix or Sequence Number The unique number of the member within the contract. Integer 20
ME011 Member Identification Code Member's social security number; used to create unique member ID Text 128
ME012 Individual Relationship Code Member's relationship to insured Integer 2
ME013 Member Gender Member's gender Text 1
ME014 Member Date of Birth Not provided Date CCYYMMDD 8
ME015 Member City Name The city location of the 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. Text 11
ME018 Medical Coverage Not provided Text 1
ME019 Prescription Drug Coverage Not provided Text 1
ME020 Dental Coverage Placeholder N/A at this time Text 1
ME021 Race 1 Placeholder N/A at this time Text 6
ME022 Race 2 Placeholder N/A at this time Text 6
ME023 Other Race Placeholder N/A at this time Text 15
ME024 Hispanic Indicator Placeholder N/A at this time Text 1
ME025 Ethnicity 1 Placeholder N/A at this time Text 6
ME026 Ethnicity 2 Placeholder N/A at this time Text 6
ME027 Other Ethnicity Placeholder N/A at this time Text 20
ME028 Primary Insurance Indicator Is insurance policy primary Text 1
ME029 Coverage Type Type of Cov Text 3
ME030 Market Category Code Category of Insurance Policy Text 4
ME031 Special Coverage Special Insurance Coverage (e.g. Catamount) Text 3
ME101 Encrypted Subscriber Last Name Encrypted subscriber last name, used to create unique member ID Text 128
ME102 Encrypted Subscriber First Name Encrypted subscriber first name, used to create unique member ID Text 128
ME103 Encrypted Subscriber Middle Initial Encrypted subscriber middle initial, used to create unique member ID Text 1
ME104 Encrypted Member Last Name Encrypted member last name, used to create unique member ID Text 128
ME105 Encrypted Member First Name Encrypted member first name, used to create unique member ID Text 128
ME106 Encrypted Member Middle Initial Encrypted member middle initial, used to create unique member ID Text 1
ME899 Record Type Value ME Text 2
TR001 Record Type Value TR Text 2
TR002 Payer Payer Code Text 8
TR003 National Plan ID CMS National Plan ID; This is not yet available. Code as null Text 30
TR004 Type of File ME Text 2
TR005 Period Beginning Date Beginning of paid period for Claims Beginning of month covered for Eligibility Integer YYYYMM 6
TR006 Period Ending Date End of paid period for Claims End of month covered for Eligibility Integer YYYYMM 6
TR007 Date Processed Not provided Date 8

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