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Dental Service Providers File Submission

Maine

Versions: Dental Service Providers File Submission• Dental Service Providers File SubmissionCompare Versions


Name:Dental Service Providers File Submission
State:Maine
Definition:Not Provided
Versionv1.2

File Specification for Dental Service Providers File Submission

Data Element ID Data Element Description Type Format Length
Multiple versionsDCSP001 Provider ID # This field is used to link the Dental provider data to the Dental claims data (DC912). It is the primary identification number for each Dental Service Provider record. CHAR 12
Multiple versionsDCSP002 Payer This field contains the MHDO submitter code for the payer submitting payments. The first character of the submitter code indicates the type of submitter. This field is primarily used for tracking compliance by payer. It is derived from DC001 in the dental claims data. CHAR 6
Multiple versionsDCSP003 Service Provider Number This is the provider number assigned by the payer. This field is derived from DC018 in the dental claims data. CHAR 30
Multiple versionsDCSP004 Service Provider Tax ID Number This field should contain the provider's tax identification number. For an individual, this code is often the social security number. This field is derived from DC019 in the dental claims data. CHAR 10
Multiple versionsDCSP005 Service Provider Entity Type Qualifier This field is used to distinguish an individual practitioner from a business entity. This field is derived from DC021 in the dental claims data. CHAR 1
Multiple versionsDCSP006 Service Provider First Name This field contains the first name of the practitioner. If the provider is a facility, this field will be blank. This field is derived from DC022 in the dental claims data. CHAR 25
Multiple versionsDCSP007 Service Provider Middle Name This field contains the practitioner's middle name or initial. This field is derived from DC023 in the dental claims data. CHAR 25
Multiple versionsDCSP008 Service Provider Last Name or Organization Name This field contains the full name of provider organization or last name of individual provider. This field is derived from DC024 in the dental claims data. CHAR 60
Multiple versionsDCSP009 Service Provider Suffix This field contains the generational suffix for the individual. This field is derived from DC025 in the dental claims data. CHAR 10
Multiple versionsDCSP010 Service Provider Specialty This field contains the specialty code assigned by the payer. Use this field to link to the provider specialty table (SP901). Since specialty codes are not unique across payers, you must also link on Payer. This field is derived from DC026 in the dental claims data. CHAR 10
Multiple versionsDCSP011 Service Provider City Name This field contains the city name of provider - preferably practice location. This field is derived from DC027 in the dental claims data. CHAR 30
Multiple versionsDCSP012 Service Provider State or Province This is the two character abbreviation for city as defined by the US Postal Service. This field is derived from DC028in the dental claims data. CHAR 2
Multiple versionsDCSP013 Service Provider ZIP Code This field contains the zip code of provider practice location. It may contain non US codes. This field is derived from DC029 in the dental claims data. CHAR 11
Multiple versionsDCSP014 Data Processing Center Provider Code This field contains the unique provider identifier that crosses all payers. This field is the link to the Dental Provider Master file (DCPM901). NUMBER 12
Multiple versionsDCSP015 Taxonomy Code This field is used to standardize the specialty coding of the provider records. It is based upon the service provider specialty code (DC032) and the linkage activity. A DPCID will have only one national TAXONOMY code. CHAR 10
Multiple versionsDCSP016 Individual Practitioner Flag This field is used to determine if the provider name may be released. Eliminated 04//01/2007 upon the release of practitioner identifiable data elements. NUMBER 1
Multiple versionsDCSP017 National Provider Identifier Not Provided CHAR 20

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Data Element ID Data Element Code Value
DCSP002 Payer C Commercial carrier
T Third Party Administrator
U Unlicensed entity
DCSP005 Service Provider Entity Type Qualifier 1 Person
2 Non-Person Entity
DCSP016 Individual Practitioner Flag 0 Release
1 Withhold
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