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Enrollee OMB Hispanic Ethnicity (Hispanic Indicator)

20, Maryland

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


Name:Enrollee OMB Hispanic Ethnicity (Hispanic Indicator)
Data Element ID:20
Description:Ethnicity of enrollee.
State:Maryland
Data Type:numeric
Length:1
Start:62
End:62
Permissible Values: Enrollee OMB Hispanic Ethnicity (Hispanic Indicator) uses the following permissible values:
Code / Value Meaning
1 Hispanic or Latino or Spanish origin
2 Not Hispanic or Latino or Not of Spanish origin
9 Missing/Unknown/Not specified
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File Specification for Multiple versionsMedical Eligibility File Submission - January 9, 2014

Data Element ID Data Element Description Type Format Length
Multiple versions1 Record Identifier The value is 5 numeric 1
Multiple versions2 Encrypted Enrollee IdentifierP (payor encrypted) Enrollee's unique identification number assigned by payor 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 +4-digit add-on Zip code of enrollee's residence. numeric 10
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 Direct Reporting of Enrollee Race Indicate the source of direct reporting of enrollee race. numeric 1
Multiple versions9 Race Category White - Direct Enter whether the self-defined race of the enrollee is White or Caucasian. White is defined as a person having lineage in any of the original peoples of Europe, the Middle East, or North Africa. numeric 1
Multiple versions10 Race Category Black or African American - Direct Enter whether the self-defined race of the enrollee is Black or African American. Black or African American is defined as a person having lineage in any of the Black racial groups of Africa. numeric 1
Multiple versions11 Race Category American Indian or Alaska Native - Direct Enter whether the self-defined race of the enrollee is American Indian or Alaska Native. American Indian or Alaska Native is defined as a person having lineage in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment. numeric 1
Multiple versions12 Race Category Asian - Direct Enter whether the self-defined race of the enrollee is Asian. Asian is defined as a person having lineage in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. numeric 1
Multiple versions13 Race Category Native Hawaiian or Other Pacific Islander - Direct Enter whether the self-defined race of the enrollee is Native Hawaiian or Other Pacific Islander. Native Hawaiian or Other Pacific Islander is defined as a person having lineage in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. numeric 1
Multiple versions14 Race Category Other - Direct Enter whether the self-defined race of the enrollee is Other. numeric 1
Multiple versions15 Race Category Declined to Answer - Direct Enter whether the enrollee declined to disclose their race. numeric 1
Multiple versions16 Race Category Unknown or Cannot Determined - Direct Enter whether the race of the enrollee is unknown or cannot be determined. numeric 1
Multiple versions17 Imputed Race with Highest Probability Race of enrollee. numeric 1
Multiple versions18 Probability of Imputed Race Assignment Specify the probability of race assignment; probability used in race determination. numeric 3
Multiple versions19 Source of Direct Reporting of Enrollee Ethnicity Indicate source of reporting enrollee ethnicity. numeric 1
Multiple versions20 Enrollee OMB Hispanic Ethnicity (Hispanic Indicator) Ethnicity of enrollee. numeric 1
Multiple versions21 Imputed Ethnicity with Highest Probability (Hispanic Indicator) Enter the Ethnicity of the enrollee. numeric 1
Multiple versions22 Probability of Imputed Ethnicity Assignment Specify the probability of ethnicity assignment; probability used in ethnicity determination. numeric 3
Multiple versions23 Enrollee Preferred Spoken Language for a Healthcare Encounter A locally relevant list of languages has been developed by the Commission. numeric 2
Multiple versions24 Coverage Type Enrollee's type of insurance coverage. alphanumeric 1
Multiple versions25 Source Company Defines the payor company that holds the beneficiary's contract; for use in characterizing contract requirements under Maryland law. alphanumeric 1
Multiple versions26 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 versions27 Policy Type Type of policy. numeric 1
Multiple versions28 Encrypted Contract or Group Number (payor encrypted) Payor assigned contract or group number for the plan sponsor using an encryption algorithm generated by the payor. alphanumeric 20
Multiple versions29 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 payor records and the same employer has the same encrypted number from year to year. alphanumeric 9
Multiple versions30 Medical Services Indicator Medical Coverage numeric 1
Multiple versions31 Pharmacy Services Indicator Prescription Drug Coverage numeric 1
Multiple versions32 Behavioral Health Services Indicator Behavioral Health Services Coverage numeric 1
Multiple versions33 Dental Services Indicator Dental Coverage numeric 1
34 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
35 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
36 Start Date of Coverage (in the month) The start date for benefits in the month (for example, if the enrollee was insured at the start of the month of January in 2014, the start date is 20140101) numeric CCYYMMDD 8
37 End Date of Coverage (in the month) The end date for benefits in the month (for example, if the enrollee was insured for the entire month of January in 2014, the end date is 20140131) numeric CCYYMMDD 8
38 Date of FIRST Enrollment The date of that the patient was initially enrolled in the plan. numeric CCYYMMDD 8
39 Date of Disenrollment The end date of enrollment for the patient in this delivery system (in this data submission time period). (see Source Company on page 72) numeric CCYYMMDD 8
40 Coverage Period End Date Contract renewal date, after which benefits, such as deductibles and out of pocket maximums reset. Not Provided CCYYMMDD 8
41 Relationship to Policyholder Member's relationship to subscriber/insured. numeric 1
42 Payor ID Number Payor assigned submission identification number. alphanumeric 4
43 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...) (Note: In your documentation on page 15, please be sure to list the source system that corresponds with the letter assigned.) For payors with all data coming from one system only, leave the field blank. alphanumeric 1
44 Grandfathered Plan Indicator Indicate if the plan qualifies as a "Grandfathered or Transitional Plan" under the Affordable Care Act (ACA). numeric 1
45 Plan or Product ID Number Payor ID number associated with an enrollee's coverage and benefits in the claim adjudication system. alphanumeric 20
46 Subscriber ID Number Subscriber ID number associated with individual or family enrollment. alphanumeric 20
47 Health Insurance Oversight System (HIOS) ID Number HIOS ID number supplied by the federal government. alphanumeric 20
48 Master Patient Index Indicates the unique patient identifier assigned by Maryland's Health Information Exchange, Chesapeake Regional Information System for our Patients (CRISP). alphanumeric 40
49 Reporting Quarter Indicate the quarter number for which the data is being submitted. numeric 1

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