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Benefit Plan Control Total File Submission

Massachusetts

Versions: June 20, 2013 - v3.1 • October 1, 2014 - v4.0Compare Versions


Name:Benefit Plan Control Total File Submission
State:Massachusetts
Definition:Not Provided
VersionOctober 1, 2014 - v4.0

File Specification for Benefit Plan Control Total File Submission

Data Element ID Data Element Description Type Format Length
Multiple versionsHD001 Type of File Defines the file type and data expected. Text char[2] 2
Multiple versionsHD002 Submitter Header Submitter / Carrier ID defined by CHIA Integer varchar[6] 6
Multiple versionsHD003 Period Beginning Date Header Period Start Date Date Period -Integer Int[6] CCYYMM 6
Multiple versionsHD004 Period Ending Date Header Period End Date Date Period -Integer Int[6] CCYYMM 6
Multiple versionsHD005 APCD Version Number Submission Guide Version Decimal - Numeric Char[3] 3
Multiple versionsHD006 Comments Header Carrier Comments Text varchar[80] 80
Multiple versionsBP001 Benefit Plan Contract ID Benefit Plan ID Text varchar[30] 30
Multiple versionsBP002 Benefit Plan Name Submitter defined benefit plan name Text varchar[70] 70
Multiple versionsBP003 Actuarial Value Actuarial value for the benefit plan Decimal varchar[6] 6
Multiple versionsBP004 Claim Type Qualifier Claim Type Identifier Code Lookup Table - Integer int[1] 1
Multiple versionsBP005 Monthly Claims Paid Number for the Benefit Plan Total Number of Claims Paid Quantity - Integer varchar[15] 15
Multiple versionsBP006 Monthly Net Dollars Paid for the Benefit Plan Total Paid Amount Integer varchar[15] 15
Multiple versionsBP007 Total Monthly Eligible Members by Benefit Plan ID Period Date Total Eligible Members Quantity - Integer varchar[15] 15
BP008 Benefit Plan Start Date Benefit Plan Start Date Full Date-Integer Int[8] CCYYMMDD 8
BP009 Benefit Plan End Date Benefit Plan End Date Full Date - Integer Int[8] CCYYMMDD 8
Multiple versionsTR001 Type of File Validates the file type defined in HD001. Text char[2] 2
Multiple versionsTR002 Submitter Trailer Submitter / Carrier ID defined by CHIA Integer varchar[6] 6
Multiple versionsTR003 Record Count Trailer Record Count Integer varchar[10] 10
Multiple versionsTR004 Date Processed Trailer Processed Date Integer Int[8] CCYYMMDD 8
Multiple versionsTR005 Period Beginning Date Trailer Period Start Date Date Period -Integer Int[6] CCYYMM 6
Multiple versionsTR006 Period Ending Date Trailer Period End Date Date Period -Integer Int[6] CCYYMM 6

Downloads
 
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Data Element ID Data Element Code Value
HD001 Type of File BP BENEFIT PLAN
HD005 APCD Version Number 3.0 Version 3.0; required for reporting periods as of October 2013; No longer valid as of May 2015.
4.0 Version 4.0 required for reporting periods October 2013 onward as of May 2015
BP004 Claim Type Qualifier 1 Medical Claim Reporting
2 Pharmacy Claim Reporting
TR001 Type of File BP BENEFIT PLAN
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