Schedule F10- Data Feed- Vision.xlsx
XLSX spreadsheet 13 KB Posted
- Attached to
- Health Insurance Database Management System
- Solicitation number
- RFP-171-250000003097-2
- Issued by
- Michigan
About this file
This is a data feed specification document for Schedule F1 Request for Proposal No. 250000003097, issued by the Michigan Office of Retirement Services for a Health Insurance Database Management System. The document provides a detailed technical specification for a standardized data file format, outlining 40 distinct data fields with precise positional requirements, including field lengths, types, and formatting rules for comprehensive healthcare claims and service data.
The specification covers intricate data capture elements such as claim details, provider information, patient demographics, financial transactions, and diagnostic codes. Key fields include Provider ID, Date of Service, Procedure Codes, Diagnosis Codes, Network Indicators, Payment Information, and unique identifiers like Family ID and NPI (National Provider Identifier). The document supports multiple diagnostic coding systems (ICD-9 and ICD-10) and includes granular financial tracking elements like copayments, deductibles, third-party amounts, and claim processing fees, suggesting a complex healthcare claims management and reporting infrastructure for the Michigan Office of Retirement Services.
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| Schedule I Sample Validation Report.xlsx | XLSX spreadsheet | |
| Schedule B - Healthcare Database.xlsx | XLSX spreadsheet | |
| Schedule F2-Data Feed Non-Medicare Medical.csv | CSV file | |
| Schedule F5- Data Feed-Medicare Lab.csv | CSV file | |
| Schedule F8- Data Feed- Medicare Pharmacy.xls | XLS spreadsheet | |
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| 250000003097 - Health Insurance Database Management System RFP.docx | DOCX document | |
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| Schedule F6- Data Feed-Hearing.xlsx | XLSX spreadsheet | |
| Schedule F7- Data Feed- Non Medicare Pharmacy.xlsx | XLSX spreadsheet | |
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Text version
Schedule F1
Request for Proposal No. 250000003097
| Health Insurance Database Management System for the Michigan Office of Retirement Services | ||||||
| Field | Start Position | End Position | Length | Field Type | Format | TR Comments |
| Adjustment Type Code | 1 | 1 | 1 | CHAR | ||
| Allowed Amount | 2 | 11 | 10 | NUMERIC | 2 decimal places | |
| Capitated Service Indicator | 12 | 12 | 1 | CHAR | ||
| Charge Submitted | 13 | 22 | 10 | NUMERIC | 2 decimal places | |
| Claim ID | 23 | 37 | 15 | CHAR | ||
| Coinsurance | 38 | 47 | 10 | NUMERIC | 2 decimal places | |
| Copayment | 48 | 57 | 10 | NUMERIC | 2 decimal places | |
| Date of Birth | 58 | 67 | 10 | DATE | MM/DD/CCYY | |
| Date of First Service | 68 | 77 | 10 | DATE | MM/DD/CCYY | |
| Date of Last Service | 78 | 87 | 10 | DATE | MM/DD/CCYY | |
| Date Paid | 88 | 97 | 10 | DATE | MM/DD/CCYY | |
| Deductible | 98 | 107 | 10 | NUMERIC | 2 decimal places | |
| Filler | 108 | 112 | 5 | CHAR | ||
| Discount | 113 | 122 | 10 | NUMERIC | 2 decimal places | |
| Family ID | 123 | 131 | 9 | CHAR | ||
| Gender Code | 132 | 132 | 1 | CHAR | ||
| Line Number | 133 | 134 | 2 | NUMERIC | ||
| Net Payment | 135 | 144 | 10 | NUMERIC | 2 decimal places | |
| Network Paid Indicator | 145 | 145 | 1 | CHAR | ||
| Network Provider Indicator | 146 | 146 | 1 | CHAR | ||
| Ordering Provider ID | 147 | 159 | 13 | CHAR | ||
| PCP Responsibility Indicator | 160 | 160 | 1 | CHAR | ||
| Place of Service Code | 161 | 162 | 2 | CHAR | ||
| Procedure Code | 163 | 167 | 5 | CHAR | ||
| Procedure Modifier Code 1 | 168 | 169 | 2 | CHAR | ||
| Provider ID | 170 | 182 | 13 | CHAR | ||
| Provider Type Code Claim | 183 | 185 | 3 | NUMERIC | ||
| Provider Zip Code | 186 | 190 | 5 | CHAR | ||
| Third Party Amount | 191 | 200 | 10 | NUMERIC | 2 decimal places | |
| Units of Service | 201 | 204 | 4 | NUMERIC | ||
| Provider Name | 205 | 234 | 30 | VARCHAR | ||
| Penalty amount (member pay) | 235 | 244 | 10 | NUMERIC | ||
| Claim Processing Fee | 245 | 254 | 10 | NUMERIC | ||
| NPI | 255 | 264 | 10 | NUMERIC | ||
| EyeMed Plan ID/Account Structure | 265 | 279 | 15 | NUMERIC | ||
| ICD-9/10 Indicator | 280 | 280 | 1 | NUMERIC | 0=ICD10 9=ICD9 | |
| Primary Diagnosis Code | 281 | 290 | 10 | CHAR | ||
| Diagnosis Code 2 | 291 | 300 | 10 | CHAR | ||
| Diagnosis Code 3 | 301 | 310 | 10 | CHAR | ||
| Diagnosis Code 4 | 311 | 320 | 10 | CHAR | ||
| Diagnosis Code 5 | 321 | 330 | 10 | CHAR | ||
| Diagnosis Code 6 | 331 | 340 | 10 | CHAR | ||
| Diagnosis Code 7 | 341 | 350 | 10 | CHAR | ||
| Diagnosis Code 8 | 351 | 360 | 10 | CHAR | ||
| Diagnosis Code 9 | 361 | 370 | 10 | CHAR | ||
| Diagnosis Code 10 | 371 | 380 | 10 | CHAR | ||
| Diagnosis Code 11 | 381 | 390 | 10 | CHAR | ||
| Diagnosis Code 12 | 391 | 400 | 10 | CHAR | ||
| Filler | 401 | 479 | 79 | CHAR | ||
| Record Type | 480 | 480 | 1 | CHAR |
File details come from the government source that posted it. Updated .