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Special Coverage

ME031, Virginia



Name:Special Coverage
Data Element ID:ME031
Description:Not Provided
State:Virginia
Data Type:varchar
Length:3
Required:O
Reference:N/A
Permissible Values: Special Coverage uses the following permissible values:
Code / Value Meaning
0 not applicable
1 - XXX reserved for VA special statewide health care coverage program(s)
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File Specification for Member Eligibility File Submission - August 2013 - v1.2

Data Element ID Data Element Description Type Format Length
HD001 Record Type Not Provided char 2
HD002 Payer Code NAIC code (example: 12345); leave blank if not applicable varchar 8
HD003 Payer Name Not Provided varchar 75
HD004 Beginning Month Not Provided date CCYYMM 6
HD005 Ending Month Not Provided date CCYYMM 6
HD006 Record count Total number of records submitted in the medical eligibility file, excluding header and trailer records int 10
ME001 Payer Name/Code Payer submitting payments-assigned by VHI (may be multiple to support different platforms, or as required) varchar 8
ME002 National Plan ID CMS National Plan ID or NAIC varchar 30
ME003 Insurance Type Code/Product Not Provided char 2
ME004 Year 4 digit Year for which eligibility is reported in this submission int 4
ME005 Month Month for which eligibility is reported in this submission expressed numerical from 01 to 12. char 2
ME006 Insured Group or Policy Number Group or policy number - not the number that uniquely identifies the subscriber varchar 30
ME007 Coverage Level Code Benefit coverage level char 3
ME008 Subscriber Social Security Number Subscriber's social security number; Set as null if unavailable varchar 9
ME009 Plan Specific Contract Number Plan assigned subscriber's contract number; Set as null if contract number = subscriber's social security number or use an alternate unique identifier such as Medicaid ID. Must be an identifier that is unique to the subscriber. varchar 128
ME010 Member Suffix or Sequence Number Unique number of the member within the contract. Must be an identifier that is unique to the member. varchar 128
ME011 Member Identification Code Member's social security number; Set as null if contract number = subscriber's social security number or use an alternate unique identifier such as Medicaid ID. Must be an identifier that is unique to the member. varchar 9
ME012 Individual Relationship Code Member's relationship to insured. char 2
ME013 Member Gender Not Provided char 1
ME014 Member Date of Birth Not Provided char CCYYMMDD 8
ME015 Member City Name City location of member varchar 30
ME016 Member State or Province As defined by the US Postal Service char 2
ME017 Member ZIP Code ZIP Code of member - may include non-US codes. Do not include dash. Plus 4 optional but desired. varchar 11
ME018 Medical Coverage Not Provided char 1
ME019 Prescription Drug Coverage Not Provided char 1
ME020 Dental Coverage Not Provided char 1
ME021 Race 1 Not Provided varchar 6
ME022 Race 2 Not Provided varchar 6
ME023 Other Race List race if MC021or MC022 are coded as R9. varchar 15
ME024 Hispanic Indicator Not Provided char 1
ME025 Ethnicity 1 Not Provided varchar 6
ME026 Ethnicity 2 Not Provided varchar 6
ME027 Other Ethnicity List ethnicity if MC025 or MC026 are coded as OTHER. varchar 20
ME028 Primary Insurance Indicator Not Provided char 1
ME029 Coverage Type Not Provided char 3
ME030 Market Category Code Not Provided varchar 4
ME031 Special Coverage Not Provided varchar 3
ME032 Group Name Group name or IND for individual policies varchar 128
ME101 Subscriber Last Name The subscriber last name varchar 128
ME102 Subscriber First Name The subscriber first name varchar 128
ME103 Subscriber Middle Initial The subscriber middle initial char 1
ME104 Member Last Name The member last name varchar 128
ME105 Member First Name The member first name varchar 128
ME201 Member Street Address Street address of member varchar 50
ME202 Employer Name Name of the Employer, or if same as Group Name, null varchar 50
ME897 Plan Effective Date Date eligibility started for this member under this plan type. The purpose of this data element is to maintain eligibility span for each member. char CCYYMMDD 8
ME899 Record Type Not Provided char 2
TR001 Record Type Not Provided char 2
TR002 Payer Code NAIC code (example: 12345); leave blank if not applicable varchar 8
TR003 Payer Name Not Provided varchar 75
TR004 Beginning Month Not Provided date CCYYMM 6
TR005 Ending Month Not Provided date CCYYMM 6
TR006 Extraction Date Not Provided date CCYYMMDD 8

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