C.M.R. 90, 590, ch. 243, app 590-243-B-1
Data Element # | Data Element Name | Date Effective | Type | Maximum Length | Description/Codes/Sources |
HD001 | Record Type | 1/1/2003 | Text | 2 | HD |
HD002 | Submitter | 1/1/2003 | Text | 8 | MHDO-assigned identifier of payor submitting claims data. Do not leave blank. |
HD003 | Payor | 7/1/2012 | Text | 8 | MHDO-assigned code of the insurer/ underwriter in the case of premiums-based coverage, or of the administrator in the case of self-funded coverage |
HD004 | Type of File | 1/1/2003 | Text | 2 | CF Capitated Payments File DC Dental Claims MC Medical Claims ME Member Eligibility PC Pharmacy Claims |
HD005 | Period Beginning Date | 1/1/2003 | Text | 6 | CCYYMM Beginning of paid period for Claims Beginning of month covered for Eligibility Beginning of performance period for Capitated Payments |
HD006 | Period Ending Date | 1/1/2003 | Text | 6 | CCYYMM End of paid period for Claims End of month covered for Eligibility End of performance period for Capitated Payments |
HD007 | Record Count | 1/1/2003 | Number | 10 | Total number of records submitted in this file Exclude header and trailer record in count |
HD008 | Comments | 1/1/2003 | Text | 80 | Submitter may use to document this submission by assigning a filename, system source, etc. |
C.M.R. 90, 590, ch. 243, app 590-243-B-1