PL 008.docx

DOCX document 45 KB Posted

Attached to
FINANCIAL MANAGEMENT SERVICES
Solicitation number
5400018925
Issued by
Richland County, South Carolina

About this file

This is a technical specification document for data exchange exports and imports between Phoenix and a Financial Management Services (FMS) Provider in South Carolina. The document outlines the system architecture and data objects required for the FMS vendor to manage consumer-directed care services, including participant matches between employers and employees, provider information, worker registration, and client data management.

The document specifies four primary export data objects from Phoenix: Provider records containing provider ID, company name, effective dates, address and phone information, and enrolled service IDs; Worker records with registration information; Client records including CLTC numbers, names, and effective dates; and FMS_Match records detailing participant-employer-employee relationships with match status, relationship codes, and termination information. The import data objects to be provided by the FMS vendor include Claim records documenting check-in and check-out times with source type indicators for IVR or mobile app transactions; FMS_Employer records containing SSN, EIN, status, contact information, and address data from Public Partnerships; FMS_Document records tracking document status and receipt dates for employee and employer documentation; and ID_Card data associated with client Q-R Cards. All data fields include specific formatting requirements, character limitations, validation standards, and field-level requirements to ensure proper system integration and claim processing for consumer-directed care services.

View the file

Other files

File Type Posted
PL 011.pdf PDF
Notice of Award Posting.doc DOC document
Attachment 9.xls XLS spreadsheet
PL 012.pdf PDF
Amendment 1.docx DOCX document
Solicitation.docx DOCX document
PL 004.jpg JPG image
PL 002.pdf PDF
PL 007.pdf PDF
PL 001.pdf PDF
PL 006.docx DOCX document
Award Extension Notice.doc DOC document
PL 010.pdf PDF
Attachment 8.xls XLS spreadsheet
PL 003.jpg JPG image
PL 013.pdf PDF
PL 005.pdf PDF
Amendment 2.docx DOCX document
PL 009.pdf PDF
Show all 19

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

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
ID
Y
64

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

AddressLine1
N
128

Alpha-numeric characters and may contain spaces or these special characters # - . ;

AddressLine2
N
128

Alpha-numeric characters and may contain spaces or these special characters# - . ;

City
N
128

Alpha characters and may contain spaces or these special characters# - . ;

State
N
2

2 characters, alpha characters only, no special characters.

ZipCode
N
9

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

PhoneNumber
N
16

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
FirstName
Y
64

Alpha characters, spaces allowed. # - . ; special characters allowed.

MiddleName
N
64
Middle initial only
Alpha characters, spaces allowed. # - . ; special characters allowed.
LastName
Y
64

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
CodeDescription
01Self
02Spouse
03Child
04Child in Law
05Sibling
06Sibling in Law
07Aunt/Uncle
08Parent
09Parent in Law
10Cousin
11Grand Parent
12Grand Child
13Niece/Nephew
14Friend/Neighbor
15None
16Fiance/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
CodeDescription
03Child
04Child in Law
05Sibling
06Sibling in Law
07Aunt/Uncle
08Parent
09Parent in Law
10Cousin
11Grand Parent
12Grand Child
13Niece/Nephew
14Friend/Neighbor
15None
16Fiance/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
CodeDescription

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.

SourceType
Y
1
2 – IVR

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
ID
Y
64

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
TypeDocument Name
EEmployee(GTG*)
EI-9
EInformation Form
ETax Exempt
EW-4
REmployer(GTG*)
RD-128
RIRS 2678
RIRS 2848
RIRS 8821
RIRS 8822
RIRS SS4
RSC 2848
RSC 8822
RSC TC-111
RSC UCE 101-S
RSC UCE 151

* Explicit Good to Go indication from PPL.

DateReceived
Y
10
Date Document received
CCYYMMDD
DateCompleted
Y
10
Date Document completed
CCYYMMDD

File details come from the government source that posted it. Updated .