J_6_DEEOIC_Claimant_Eligibility_File_Layout.xlsx
XLSX spreadsheet 23 KB Posted
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- 1605C3-21-R-00011
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Sheet1
| Field | Field Name | Description | Type | Mandatory (YES/NO) | Sample Data | Current Validation and Error Message |
| Header: (Record Length EXT=796) (1 Header Line Only) MB2021070700000009500000062707/07/2021 | ||||||
| 1 | FILE_NAME | The name of the file – ECS uses the file name format defined below: • 1st node - program (static 'MB') |
• 2th node - creation date
| CHAR(10) | YES | MB20210707 | |||||
| 2 | COUNT OF DISTINCT MEDICAL COMP IDS | CHAR(9) | YES | 000000095 | |||
| 3 | COUNT OF RECORDS IN FILE | CHAR(9) | YES | 000000627 | |||
| 4 | DATE_CREATED | The date the file was created | CHAR (10) | YES | 07/07/2021 | ||
| 5 | FILLER | Blank Spaces: | |||||
| Ext file is 758 | CHAR(758) | YES | |||||
| Detail: (Record Length EXT=796) | |||||||
| 1 | IMDOLR06-CAS-EMP-SSN | Employee Social Security Number (SSN) on the Case | CHAR(9) | YES | 123456789 | IF IMDOLR06-CAS-EMP-SSN IS NOT A NUMERIC VALUE THEN REJECT THE UPDATE WITH ERROR MESSAGE: |
“SSN NUM SPACES OR ZEROS”
| 2 | IMDOLR06-CAS-EMP-LNAME | Employee Last Name for the Case | CHAR(30) | YES | Doe | |
| 3 | IMDOLR06-CAS-EMP-FNAME | Employee First Name for the Case | CHAR(30) | YES | Jane | |
| 4 | IMDOLR06-CAS-EMP-MI | Employee Middle Name/Initial for the Case | CHAR | NO | M | |
| 5 | IMDOLR06-CAS-EMP-SEX | Employee Sex | CHAR | NO | F | IF IMDOLR06-CAS-EMP-SEX DOES NOT EQUAL “F” OR “M” THEN REJECT RECORD WITH ERROR MESSAGE: |
“SEX CODE IS INVALID”
| 6 | IMDOLR06-CAS-EMP-DOB | Employee Date of Birth (DOB) | CHAR(10) | YES | 999999999 | |
| 7 | IMDOLR06-CAS-UPDT-DT | Case Update Date | CHAR(10) | YES | 999999999 | IF IMDOLR06-CAS-UPDT-DT EQUAL ZEROES THEN REJECT RECORD WITH ERROR MESSAGE: |
“CASE UPDATE DT INVALID”
| 8 | IMDOLR06-PAYEE-PAYEE-MAIL-NAME | Payee Mail Name | CHAR(35) | NO | Jane Doe | |
| 9 | IMDOLR06-PAYEE-PAYEE-ADDR-1 | Payee Address Line 1 | CHAR(35) | YES | 1000 Sprinthill Lane | |
| 10 | IMDOLR06-PAYEE-PAYEE-ADDR-2 | Payee Address Line 2 | CHAR(35) | NO | ||
| 11 | IMDOLR06-PAYEE-PAYEE-ADDR-3 | Payee Address Line 31 | CHAR(35) | NO | ||
| 12 | IMDOLR06-PAYEE-PAYEE-CITY | Payee City | CHAR(20) | YES | Greenbelt | |
| 13 | IMDOLR06-PAYEE-PAYEE-STATE | Payee State | CHAR(2) | YES | MD | |
| 14 | IMDOLR06-PAYEE-PAYEE-ZIP | Payee Zip Code | CHAR(9) | YES (Zip 5 only for Domestic Address) | 20770 | |
| 15 | IMDOLR06-CAS-DIST-OFFICE-CD | District Office Code | CHAR(3) | YES | CLE | IF IMDOLR06-CAS-DIST-OFFICE-CD IS NOT EQUAL TO DISTRICT IDS “CLE”, “DEN”, “JAC”, “NAT”, OR “SEA” THEN REJECT THE RECORD WITH ERROR MESSAGE: |
“DISTRICT CODE INVALID”
16 IMDOLR06-CAS-EMP-DOD Employee Date of Death (DOD) CHAR(10) NO 999999999 • IF IMDOLR06-CAS-EMP-DOD IS AN INVALID VALUE THEN REJECT RECORD WITH ERROR MESSAGE:
“DT OF DEATH NOT NUMERIC”
• IF IMDOLR06-CAS-EMP-DOD IS GREATER THAN THE CURRENT DATE THEN REJECT RECORD WITH ERROR MESSAGE:
“DATE OF DEATH IN FUTURE”
| 17 | IMDOLR06-PAYEE-PAYEE-PHONE | Payee Phone Number | CHAR(10) | NO | 9999999999 | |
| 18 | IMDOLR06-CAS-CE-USER-NM | Claims Examiner (CE) User Name | CHAR(8) | NO | ceuserid | |
| 19 | IMDOLR06-CLAIM-CLAIM-FILED-DT | Claim File Date | CHAR(10) | NO | 999999999 | IF IMDOLR06-CLAIM-CLAIM-FILED-DT EQUAL ZEROES THEN REJECT THE RECORD WITH ERROR MESSAGE: |
“CLAIM FILE DATE INVALID”
20 IMDOLR06-ADJUDICATION-STATUS-CD Adjudication Status Code CHAR(1) NO A IF IMDOLR06-ADJUDICATION-STAT-CD IS NOT EQUAL TO “A”, “D”, OR “U” THEN REJECT THE RECORD WITH ERROR MESSAGE:
“ADJUD STATUS INVALID”
21 IMDOLR06-ADJUDICATION-DT Adjudication Date CHAR(10) NO 999999999 IF IMDOLR06-ADJUDICATION-DT IS EQUAL TO ZEROES THEN REJECT RECORD WITH ERROR MESSAGE:
“ADJUD DATE INVALID”
22 IMDOLR06-MED-COND-STATUS Medical Condition Status CHAR(1) NO A Valid Medical Condition Status values are:
A = Allowed O = Offset 23 IMDOLR06-MED-COND-ICD-VER Medical Condition ICD Version CHAR(2) YES 10 • IF IMDOLR06-MED-COND-ICD9-10-IND = “10” AND IMDOLR06-MED-COND-ICD9-10-CD IS NOT A ICD-10 DX THEN REJECT RECORD WITH ERROR MESSAGE:
“INVALID ICD10 DIAG CODE”
• IF IMDOLR06-MED-COND-ICD9-10-IND EQUAL “09” AND IMDOLR06-MED-COND-STAT-EFF-DT IS GREATER THAN ICD-10 EFFECTIVE DATE THEN REJECT RECORD WITH ERROR MESSAGE:
“ACCEPTED ICD9 EFF DT > PARM DTE”
• IF IMDOLR06-MED-COND-ICD9-10-IND EQUAL “10” AND IMDOLR06-MED-COND-STAT-EFF-DT IS LESS THAN ICD-10 EFFECTIVE DATE THEN REJECT RECORD WITH ERROR MESSAGE:
“ICD10 EFF DT < PARM DTE”
| 24 | IMDOLR06-MED-COND-ICD-CD | Medical Condition ICD Code | CHAR(7) | YES | C760 | |
| 25 | IMDOLR06-MED-COND-STAT-EFF-DT | Medical Condition Status Effective Date | CHAR(10) | YES | 12152017 | • IF IMDOLR06-MED-COND-STAT-EFF-DT EQUAL 1 THEN REJECT RECORD WITH ERROR MESSAGE: |
“COND BEG DATE < 1964”
• IF IMDOLR06-MED-COND-STAT-EFF-DT EQUAL ZEROES THEN REJECT RECORD WITH ERROR MESSAGE:
“COND BEG DATE INVALID”
26 IMDOLR06-MED-COND-ELIG-END-DT Condition Eligibility End Date CHAR(10) NO 99999999 • IF IMDOLR06-MED-COND-ELIG-END-DT EQUAL 1 THEN REJECT RECORD WITH ERROR MESSAGE:
“COND END DATE < 1964”
• IF IMDOLR06-MED-COND-ELIG-END-DT < IMDOLR06-MED-COND-STAT-EFF-DT THEN REJECT RECORD WITH ERROR MESSAGE:
“COND END DATE < BEG DATE”
• IF IMDOLR06-MED-COND-ELIG-END-DT IS AN INVALID VALUE THEN REJECT RECORD WITH ERROR MESSAGE:
“COND END DATE INVALID”
27 IMDOLR06-MED-COND-ID Medical Condition Identifier CHAR(16) YES 1 IF THE NUMBER OF ACCEPTED CONDITIONS RECEIVED IS GREATER THAN 999 THEN REJECT THE EXCESSIVE RECORDS WITH ERROR MESSAGE:
“MEMBER HAS > 200 UPDATES”
28 IMDOLR06-CAS-CHK-SAV-IND Checking Savings Indicator CHAR(1) NO S The valid Checking Savings Indicator values are:
C = Checking S = Savings
| 29 | IMDOLR06-CAS-BANK-RTE-NUM | Bank Routing Number | CHAR(9) | NO | 123123123 | |
| 30 | IMDOLR06-CAS-BANK-ACCT-NUM | Bank Account Number | CHAR(17) | NO | 6976236 | |
| 31 | IMDOLR06-CASE_ID | Case Identifier | CHAR(10) | YES | 1234567890 | |
| 32 | IMDOLR06-CE_LNAME | Claims Examiner (CE) Last Name | CHAR(50) | YES | Doe | The CE-USER-ID is already included in the file. It is based on the DOL username. |
| 33 | IMDOLR06-CE_MNAME | Claims Examiner (CE) Middle Name | CHAR(50) | NO | M | |
| 34 | IMDOLR06-CE_FNAME | Claims Examiner (CE) First Name | CHAR(50) | YES | Jane | |
| 35 | IMDOLR06-MBE_USER-ID | Medical Benefits Examiner (MBE) Userid | CHAR (8 ) | NO | Userid01 | The MBE-USER-ID is based on the DOL username. |
| 36 | IMDOLR06-MBE_LNAME | Medical Benefits Examiner (MBE) Last Name | CHAR (50 ) | NO | Doe | |
| 37 | IMDOLR06-MBE_MNAME | Medical Benefits Examiner (MBE) Middle Name | CHAR (50 ) | NO | M | |
| 38 | IMDOLR06-MBE_FNAME | Medical Benefits Examiner (MBE) First Name | CHAR (50 ) | NO | Jane | |
| 39 | IMDOLR06-COUNTRY_CODE | Country Code | CHAR (2) | YES | US | “US” if Domestic Address |
| 40 | IMDOLR06-COUNTRY_NAME | Country Name | CHAR(60) | YES | UNITED STATES | “UNITED STATES” if Domestic Address |
| 41 | IMDOLR06-CLAIMANT_ID | Claimant Identifier | CHAR(10) | YES | 9876543210 | BAS will only include the Claimant ID for the Employees that are eligible for Medical Benefits in the Claimant Eligibility File. |
Note – Employees not eligible for Medical Benefits and Survivors will not be included in this batch file.
| 42 | IMDOLR06-OFFSET_CHANGE_EFF_DT | Offset Balance Date | CHAR(10) | NO | 99999999 | Initially Blank |
| 43 | IMDOLR06-OFFSET_AMOUNT | Offset Starting Amount | DECIMAL (9,2) | NO | 1435.99 | BAS will only send the positive Offset Starting Amount. More discussions are needed with Policy to finalize. |
&F
File details come from the government source that posted it. Updated .