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All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Payer PCSP901 2010-03-16 Maine
Payer PCSP901 v1.1 Maine
Data Element: Payer PCSP901 - 2010-03-16
(Maine)
Payer PCSP901 - v1.1
(Maine)
[Shared]Data Element ID PCSP901 PCSP901
[Unshared]Definition 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 PC001 in the pharmacy claims data.
[Shared] State / Source Maine
Maine
[Unshared]Data Type varchar CHAR
[Shared]Length 6 6
[Shared]Field Name PAYER PAYER
[Unshared]Date Required Not Supplied '2003-01-31
[Unshared]REF PC001 Not Supplied
[Unshared]Warnings Not Supplied A single payer may have multiple submitter codes because the payer is submitting from more than one system or from more than one location. All submitter codes associated with a single payer will have the same first 5 characters. A suffix will be used to distinguish the location and/or system variations. For a variety of reasons, the Data Bank may include submissions from unlicensed entities. The unlicensed entities will have a payer code beginning with the letter U. If the submitter does become licensed in Maine, the first letter of the payer code will be changed to the appropriate value of C or T and the trailing four characters will remain unchanged. Therefore, a payer code of U0756 may become T0756 in the future. Note that due to administrative relationships between payers, it is possible that one or more payers are responsible for submitting eligibility data that applies to a single claims submission and vice versa. The use of payer code alone may not be sufficient to identify all claims and eligibility data associated with that payer.
Data Element: Payer PCSP901 - 2010-03-16
(Maine)
Payer PCSP901 - v1.1
(Maine)
[Unshared]C Not Utilized Commercial carrier
[Unshared]T Not Utilized Third Party Administrator
[Unshared]U Not Utilized Unlicensed entity
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