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All Payer Claims: Data Element Comparison

Selected Items
Action Name Data Element ID Version State/Organization
Deductible Amount PC042 2010-03-16 Maine
Deductible Amount PC042 v1.2 Maine
Data Element: Deductible Amount PC042 - 2010-03-16
(Maine)
Deductible Amount PC042 - v1.2
(Maine)
[Shared]Data Element ID PC042 PC042
[Unshared]Definition Not Provided This is an amount that is required to be paid by a member Before health plan benefits will begin to reimburse for Services. It is usually an annual amount of all health care costs that is not covered by the member's insurance plan. This is a money field containing dollars and cents with an implied decimal point. This field may contain a negative value.
[Shared] State / Source Maine
Maine
[Unshared]Data Type decimal NUMBER
[Shared]Length 10 10
[Shared]Field Name DED DED
[Unshared]DATE AVAIL '1/1/2003 Not Supplied
[Unshared]Date Required Not Supplied '2003-01-31
[Unshared]Warnings Not Supplied Not all payers can distinguish between the mutually exclusive fields of copay, coinsurance amount and deductible. To determine the total out of pocket/member responsibility for this service you must sum all three fields. (PC040,PC041, PC042) Payers must verify submissions with less than 25% of the records containing a member payment (coinsurance amount, deductible amount, copay).
Data Element: Deductible Amount PC042 - 2010-03-16
(Maine)
Deductible Amount PC042 - v1.2
(Maine)
There are no enumerated permissible values for these data elements.
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