Level Of Care File to EB.xls
XLS spreadsheet 79 KB Posted
- Solicitation number
- RFP 27-87793
- Issued by
- Marion County, Indiana
About this file
This is an Interface Specification document for the Level of Care File to EB (Entity/Business), a data exchange mechanism between DXC and the EB system within the Indiana Managed Care program (Title XIX). The interface specification defines the monthly and quarterly transmission of level of care data via secure FTP in compressed zip file format (LOCyyyymmdd.nnnn.zip), with the file containing member eligibility and care level assignments sourced from the Medicaid management system. The specification establishes record layout requirements including 12-character Medicaid IDs, effective and end dates in CCYYMMDD format, provider identifiers, and a five-character level of care code field, with all detail records followed by a trailer record containing physical record count validation.
The specification document includes detailed field-by-field layout requirements with character positions, data types, and table references for system integration purposes. The Level of Care codes defined in the specification encompass 28 distinct program types across four code categories: Hospice programs (51H-54H), nursing facility care levels including intermediate and skilled care (NHI10, NHI11, NHI13, NHI20, NHN, NHS10, NHS11, NHS13), and waivers including Aged and Disabled, Autism, Community Integration and Habilitation, MFP Demonstration initiatives, PRTF transitions, Family Supports, and Traumatic Brain Injury programs. The specification has undergone modifications as recently as May 2021 to enforce data integrity requirements, with all Medicaid ID, effective date, end date, and level of care code fields marked as NOT NULL to ensure complete record submission.
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Text version
Interface Spec Overview
| Interface Specification Overview | |
| Interface name: Level of Care File to EB | |
| Description: This file provides level of care data to the EB from DXC. | |
| Record Selection Criteria: MC_FTS_MGDJS622 | |
| Frequency: Monthly and quarterly | |
| Sender: DXC | |
| Receiver: EB | |
| Business Unit Ownership: Managed Care | |
| Error Handling/Special Processing: N/A | |
| Interface Exchange Method: Secure FTP | |
| File Name: LOCyyyymmdd.nnnn.zip | |
| Modification Log | |
| Change Description | Date |
| Increase Code Level of Care from 3 to 5 | 8/21/14 |
| Change Listing of LOC Codes | 8/21/14 |
| Code Level of Care - NOT NULL changed to NOT NULL; see LOC CODES tab for valid values | 5/19/21 |
Interface Specs Layout
| Enter one line for each field on the table. All columns must be completed for all rows. Add lines as needed. Add tables as needed. Only related subsystem tables should be in the same spreadsheet. | See Interface Spec Process & Interface Spec Documentation Instructions | ||||||||
| Record Type | FIELD | FIELD SIZE | Field Start | Field End | FORMAT | TABLE NAME | COLUMN | DESCRIPTION | NOTES |
| Record Type | Field name | number of characters | Start Position | End Position | field type | table of origin/destination | column name | Any relevant information such as where field originated, unique or identifying information, acronymns speeled out. | |
| Detail | Medicaid ID | 12 | 1 | 12 | CHAR | t_re_base | id_medicare | Identifies Member (RID) or Recipient ID | NOT NULL |
| Detail | Filler | 1 | 13 | 13 | space | ||||
| Detail | LOC Date Effective | 8 | 14 | 21 | NUMBER | t_re_assign_plan | dte_effective | Start date. "CCYYMMDD" | NOT NULL |
| Detail | Filler | 1 | 22 | 22 | space | ||||
| Detail | LOC Date End | 8 | 23 | 30 | NUMBER | t_re_assign_plan | dte_end | Ending date. "CCYYMMDD" | NOT NULL |
| Detail | Filler | 1 | 31 | 31 | space | ||||
| Detail | Provider ID | 9 | 32 | 40 | CHAR | t_pr_identifier | id_provider | Provider ID | NULL |
| Detail | Filler | 1 | 41 | 41 | space | ||||
| Detail | Code Level of Care | 5 | 42 | 46 | CHAR | t_pub_hlth_pgm | cde_pgm_health | Code of the Level of Care | NOT NULL; see LOC CODES tab for valid values |
| Detail | Filler | 1 | 47 | 47 | newline character | ||||
| Trailer | Filler | 3 | 1 | 3 | TRL' constant | ||||
| Trailer | Record Count | 11 | 4 | 14 | NUMBER | Physical Record count (not including trailer), right justify the number | |||
| Trailer | Filler | 32 | 15 | 46 | Space. To fill out the rest of the record | ||||
| Trailer | Filler | 1 | 47 | 47 | newline character |
&L&G&C&"Arial,Bold"&12Interface Specification Document&R&8&D &L&8&F&C&8&P of &N &R&8EDS - Indiana Title XIX 950 N. Meridian St., Suite 1150 Indianapolis, IN 46204
LOC Codes
| LOC Code | Description of Code | Type of code |
| 51H | Hospice Program; Auth for 1st 90 day period | H |
| 52H | Hospice Program; Auth for 2nd 90 day period | H |
| 53H | Hospice Pgm; Auth for 3rd period; unlimited 60 day | H |
| 54H | Hospice Program; Authorization open ended | H |
| NHI10 | General Intermediate Care in AIDS NF | N |
| NHI11 | MR/DD Specialized Intermediate Care in NF | N |
| NHI13 | AIDS Intermediate Care in NF | N |
| NHI20 | ICF/IID | N |
| NHN | Nursing Facility Level of Care | N |
| NHS10 | General Skilled Care in AIDS NF | N |
| NHS11 | MR/DD Specialized Skilled Care in NF | N |
| NHS13 | AIDs Skilled Care Unit in NF | N |
| ADWA | Aged and Disabled Waiver | W |
| AUWA | Autism Waiver | W |
| DDWA | Community Integration and Habilitation Waiver | W |
| MFPAD | MFP Demonstration Grant | W |
| MFPCI | MFP Community Integration and Habilitation | W |
| MFPTB | MFP Traumatic Brain Injury | W |
| MFPTR | MFP PRTF Transition from PRTF | W |
| MFPTS | MFP Transition from State Owned Facility | W |
| PRTCA | CA PRTF Demonstration Grant | W |
| PRTFW | PRTF Transition Waiver | W |
| SSFS | Family Supports Waiver | W |
| TBIWA | Traumatic Brain Injury Waiver | W |
File details come from the government source that posted it. Updated .