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DATA Exchange
EXPORTS from Phoenix These are methods where Phoenix will push reference data changes to the FMS Provider.
Data Objects The following Data Objects can be exported:
· Provider – Provider information including approved services
· Worker – Worker information including registered services
· Client (Participant or Consumer) – Client information including registered phone numbers, addresses, and locations
· FMS_Match – Participant, Employer, and Employee matches for consumer-directed care
Object: Provider The Provider data from Phoenix will contain the following:
| Field |
| Required? |
| Max Chars |
| Description |
| Standard Content Validation |
6 character provider ID (alphanumeric) – FMS is EXG300, FMS Providers modeled as workers under EXG300
| CompanyName |
| Y |
| 256 |
| “Provider name” |
| Alphanumeric characters, spaces, and |
# - . ; special characters allowed.
| BeginDate |
| Y |
| 14 |
| Effective Start Date for the Provider. Effective Dates are used to determine if an entity is eligible to be part of a claim. |
| CCYYMMDDHHNNSS |
| EndDate |
| N |
| 14 |
| Effective End Date for the Provider. Effective Dates are used to determine if an entity is eligible to be part of a claim. If left blank, this field is considered open-ended and does not apply to the eligibility check. |
| CCYYMMDDHHNNSS Max: 12/30/2099 |
Can be blank
Address/Location Information - Multiple Entries can be Stored, One of each type, Type is User defined
| AddressType |
| N |
| 5 |
| (Collection if multiple addresses are sent) |
| Reserved for primary addresses. Other types are user defined. |
1=Home, 2=Work, 3=Billing, 4=Other
Alpha-numeric characters and may contain spaces or these special characters # - . ;
Alpha-numeric characters and may contain spaces or these special characters# - . ;
Alpha characters and may contain spaces or these special characters# - . ;
2 characters, alpha characters only, no special characters.
5 or 9 digit zip – 111112222
Phone Information- Collection (Multiple Entries can be Stored, ONE of each type allowed)
| PhoneType |
| N |
| 5 |
| (Collection if multiple phone numbers are sent) ONE of each type is allowed. |
| Home, Work, Mobile, Fax are reserved for primary phone numbers. Other types are user defined. |
1 = Home, 2 = Work, 3 = Mobile, 4 = Fax, 5 = Other
Phone number format:
3335551212
Provider Services (collection)
| ServiceId |
| Y |
| 64 |
| A list of services the provider is “enrolled” to provide |
| Collection of alphanumeric service IDs |
Object: Client The Client data from Phoenix will contain the following:
| Field |
| Required? |
| Max Chars |
| Description |
| Standard Content Validation |
| ID |
| Y |
| 64 |
| CLTC Number |
| 7 numeric characters |
Alpha characters, spaces allowed. # - . ; special characters allowed.
| MiddleName |
| N |
| 64 |
| Middle initial only |
| Alpha characters, spaces allowed. # - . ; special characters allowed. |
Alpha characters, spaces allowed. # - . ; special characters allowed.
| EndDate |
| N |
| 14 |
| Becomes inactive date |
| CCYYMMDDHHNNSS Max: 12/30/2099 |
Can be blank
Object: FMS_Match The FMS Match data from Phoenix will contain the following:
| Field |
| Required? |
| Max Chars |
| Description |
| Standard Content Validation |
| MatchNumber |
| Y |
| 20 |
| Unique Identifier for Match |
| Numeric |
| MatchStatus |
| Y |
| 1 |
| Active, Inactive, or Terminated |
| 0 = Inactive |
1 = Active 2 = Terminated
| ClientID |
| Y |
| 7 |
| Participant CLTC Number |
| 7 numeric characters |
| MedicaidID |
| Y |
| 64 |
| Participant Medicaid Number |
| 10 numeric characters |
| ERSSN |
| Y |
| 9 |
| Employer SSN |
| 9 numeric characters |
| ERLastName |
| Y |
| 64 |
| Employer Last Name |
| Alpha characters, spaces allowed. /-.'&;# special characters allowed. |
| ERFirstName |
| Y |
| 64 |
| Employer First Name |
| Alpha characters, spaces allowed. /-.'&;# special characters allowed. |
| ERRelationship | |
| Y | |
| 2 | |
| Employer Relationship to Participant | |
| Code | Description |
| 01 | Self | |
| 02 | Spouse | |
| 03 | Child | |
| 04 | Child in Law | |
| 05 | Sibling | |
| 06 | Sibling in Law | |
| 07 | Aunt/Uncle | |
| 08 | Parent | |
| 09 | Parent in Law | |
| 10 | Cousin | |
| 11 | Grand Parent | |
| 12 | Grand Child | |
| 13 | Niece/Nephew | |
| 14 | Friend/Neighbor | |
| 15 | None | |
| 16 | Fiance/Fiancee | |
| EESSN |
| Y |
| 9 |
| Employee SSN |
| 9 numeric characters |
| EEProviderID |
| N |
| 6 |
| Employee Provider ID |
| 6 character provider ID (alphanumeric) |
| EEFirstName |
| Y |
| 64 |
| Employee First Name |
| Alpha characters, spaces allowed. /-.'&;# special characters allowed. |
| EELastName |
| Y |
| 64 |
| Employee Last Name |
| Alpha characters, spaces allowed. /-.'&;# special characters allowed. |
| EERelationship | |
| Y | |
| 2 | |
| Employee Relationship to Participant | |
| Code | Description |
| 03 | Child | |
| 04 | Child in Law | |
| 05 | Sibling | |
| 06 | Sibling in Law | |
| 07 | Aunt/Uncle | |
| 08 | Parent | |
| 09 | Parent in Law | |
| 10 | Cousin | |
| 11 | Grand Parent | |
| 12 | Grand Child | |
| 13 | Niece/Nephew | |
| 14 | Friend/Neighbor | |
| 15 | None | |
| 16 | Fiance/Fiancee | |
| EELivesWithER |
| Y |
| 1 |
| Employee Lives With Employer |
| 1 = True, 0 = False |
| EELivesWithClient |
| Y |
| 1 |
| Employee Lives With Client |
| 1 = True, 0 = False |
| MatchVisitRequired |
| Y |
| 1 |
| Match Visit Required |
| 1 = True, 0 = False |
MatchVisit Successful
| Y |
| 1 |
| Match Visit Successful |
| 1 = True, 0 = False |
| MatchVisitDate |
| N |
| 14 |
| Match Visit Date |
| CCYYMMDDHHNNSS |
| TerminationDate |
| N |
| 8 |
| Date Employment Ended |
| CCYYMMDD |
| TerminationReason | |
| N | |
| 5 | |
| Reason the EE terminated | |
| Code | Description |
01 Verbal Resignation 02 Written Resignation 03 Suspended – Nursing Home 04 Suspended – Hospital 05 Suspended – Other 06 Fired 07 Terminated – Deceased 08 Terminated – Nursing Home
Termination Comment
| N |
| 128 |
| Additional Comments. Required for codes 05, 06 |
| Alpha characters, spaces allowed. /-.'&;# special characters allowed. |
IMPORTS to the FMS Vendor
Data Objects The following Data Objects can be Imported:
· Claim (Check-in and Checkout Information) – This information includes ANI phone number and registered phone numbers at the time of an IVRS call, or location and registered locations at the time of a Mobile app transaction.
· FMS_Employer – FMS registration Employer record and EIN from Public Partnerships (PPL).
· FMS_Document – FMS registration document status from Public Partnerships (PPL).
· ID_Card – ID card data associated with a Client ID card (Q-R Card) Object: Claim The claim data will be printed on the check stub and contain the following.
| Field |
| Required? |
| Max Chars |
| Description |
| Standard Content Validation |
| ClaimID |
| Y |
| 64 |
| Unique Identifier for claim |
| nnnnn – continue to use this format for creating claims IDs in AuthentiCare. |
| ClaimGroupID |
| N |
| 64 |
| First claim number for visits with more than one client or service |
| nnnnn (All claims from the same visit will have the same Claim Group Number.) – This is where AuthentiCare will group the claims. |
Blank if not in a Group
| ClientID |
| Y |
| 64 |
| 7-digit CLTC Number |
| 7 numeric characters |
| ServiceID |
| Y |
| 64 |
| Actual service provided |
| SC uses numeric service identifier from Phoenix (Alphanumeric characters allowed in AuthentiCare) |
| ProviderID |
| Y |
| 64 |
| Actual Provider ID |
| 6 numeric characters |
(If FMS, return the Rendering Provider ID from the Worker record.)
| WorkerID |
| Y |
| 64 |
| Worker ID |
| 8 numeric characters |
| CheckInTime |
| N (Either In or Out required) |
| 14 |
| Check-In time |
| CCYYMMDDHHNNSS |
1900-01-01 00:00:00.000 indicates a time-based claim where a Check-out was performed without a Check-In.
| CheckOutTime |
| N |
| 14 |
| Check-Out time |
| CCYYMMDDHHNNSS |
Blank for check in only services 2099-12-31 00:00:00.000 indicates a time-based claim that has yet to be checked out.
4 – Mobile Set when claim created, doesn’t change
Object: FMS_Employer The FMS Employers data to Phoenix will contain the following:
| Field |
| Required? |
| Max Chars |
| Description |
| Standard Content Validation |
6 character ID
| SSN |
| Y |
| 9 |
| Employer SSN |
| 9-digit numeric |
| FID |
| Y |
| 9 |
| Employer FID (EIN) |
| 9-digit numeric |
| Status |
| Y |
| 1 |
| Employer Status |
| 0 = Inactive, 1 = Active, |
3 = Terminated
| FirstName |
| Y |
| 64 |
| Employer First Name |
| Alpha characters, spaces allowed. /-.'&;# special characters allowed. |
| LastName |
| Y |
| 64 |
| Employer Last Name |
| Alpha characters, spaces allowed. /-.'&;# special characters allowed. |
| PhoneType |
| N |
| 5 |
| (Collection if multiple phone numbers are sent) ONE of each type is allowed. |
| Home, Work, Mobile, Fax are reserved for primary phone numbers. Other types are user defined. |
1 = Home, 2 = Work, 3 = Mobile, 4 = Fax, 5 = Other
| PhoneNumber |
| Y |
| 16 |
| Employer Phone Number |
| Phone number format: |
3335551212
| AddressType |
| N |
| 5 |
| (Collection if multiple addressesare sent) ONE of each type is allowed. |
| Home, Work, Mobile, Fax are reserved for primary phone numbers. Other types are user defined. |
1 = Home, 2 = Work, 3 = Billing, 4 = Other
| AddressLine1 |
| Y |
| 128 |
| Employer Address Line 1 |
| Alpha-numeric characters and may contain spaces or these special characters.,-‘& # |
| AddressLine2 |
| Y |
| 128 |
| Employer Address Line 2 |
| Alpha-numeric characters and may contain spaces or these special characters.,-‘& # |
| City |
| Y |
| 128 |
| Employer City |
| Alpha characters and may contain spaces or these special characters.,-‘& |
| State |
| Y |
| 2 |
| Employer State |
| 2 characters, alpha characters only, no special characters. |
| ZipCode |
| Y |
| 9 |
| Employer Zip Code |
| 5 or 9 digit zip – 111112222 |
| Email |
| Y |
| 75 |
| Employer Email Address |
| ___@___.___ |
Object: FMS_Document The FMS Documents data to Phoenix will contain the following:
| Field |
| Required? |
| Max Chars |
| Description |
| Standard Content Validation |
| MedicaidID |
| Y |
| 64 |
| Medicaid ID for the Document |
| 10 numeric characters |
| ERSSN |
| Y |
| 9 |
| Employer SSN for the Document |
| 9 numeric characters |
| EESSN |
| Y |
| 9 |
| Employee SSN for the Document |
| 9 numeric characters |
| DocumentType |
| Y |
| 1 |
| Document Type |
| E – Employee, |
R – Employer
| DocumentName | |
| Y | |
| 64 | |
| Document Name | |
| Type | Document Name |
| E | Employee | (GTG*) |
| E | I-9 | |
| E | Information Form | |
| E | Tax Exempt | |
| E | W-4 | |
| R | Employer | (GTG*) |
| R | D-128 | |
| R | IRS 2678 | |
| R | IRS 2848 | |
| R | IRS 8821 | |
| R | IRS 8822 | |
| R | IRS SS4 | |
| R | SC 2848 | |
| R | SC 8822 | |
| R | SC TC-111 | |
| R | SC UCE 101-S | |
| R | SC UCE 151 | |
* Explicit Good to Go indication from PPL.
| DateReceived |
| Y |
| 10 |
| Date Document received |
| CCYYMMDD |
| DateCompleted |
| Y |
| 10 |
| Date Document completed |
| CCYYMMDD |