Output
Technical Name
TPL O Health Insurance to OCSS
Description
Monthly health insurance interface to OCSS. This file includes member eligibility
information for members on Peachcare and Medicaid who are also covered by other insurance. It is an updates only file triggered by updates to the other insurance.
File Layout
05 WS-CHILD-SSN PIC 9(09). 05 WS-CHILD-DOB PIC X(10). 05 WS-CHILD-LAST-NAME PIC X(20). 05 WS-CHILD-MIDDLE-NAME PIC X(01). 05 WS-CHILD-FIRST-NAME PIC X(15). 05 WS-CHILD-MHN-ID PIC X(13). 05 WS-CHILD-DCH-IND PIC X(01). 05 WS-CHILD-DCH-IND-DT PIC X(10).Object Status
Status Date Status Responsible Person
5/4/2009 12:47:01 PM Identified - New Demaray, Matt 5/4/2009 12:48:52 PM Documented Demaray, Matt 5/15/2009 4:55:50 PM Approved
1.17 Incoming OCSS Interface
Type
Technical Name
TPL I OCSSDescription
Incoming interface from OCSS to the MMIS. Records received will be processed and used to update the absent parent data on file.
Frequency: Monthly
File LayoutDCH / OCSE Interface File Layout
Note: The file is structured to allow for one policy per record. Therefore, it is possible that more than one record may exist for a case number on the file sent by CSE and received by CSE. Since there is no way of knowing how many different policies exist for an
individual, this seems like the cleanest way of sending the data.
Field Name Format Description /
Comments Populated on Input to ACS from CSE?*
Populated on output from ACS to CSE?*
CASE INFORMATION
DMA-IVD-CASE-NUM 9(09) Case number randomly assigned to the $TARS case
A A
DMA-MED-INS-ORDERED X(01) Code indicating whether NCP is ordered to provide medical insurance “Y” – NCP is ordered “N” – NCP is not court ordered A N
DMA-UPDT-IND X(01) Indicates that the
record has been updated by CSE since last record
A N
INSURANCE INFORMATION
DMA-INS-POLICY-NUM X(20) Insurance Policy
DMA-INS-POLICY-
GROUP-NUM X(20) Insurance Policy Group Number. C C
DMA-INS-POLICY-EFF-DT X(08) The effective date of the Insurance coverage. Format CCYYMMDD
A A
DMA-INS-POLICY-EXP-DT X(08) The expiration date of the Insurance coverage. Format CCYYMMDD
A A
DMA-INS-CARRIER-ID X(10) The MHN Carrier ID of the insurance company.
A A
DMA-INS-TYPE X(01) Indicates type of
coverage: M-Medical D-Dental V-Vision
C-Comprehensive: Medical, Dental & Mental Health
A A
DMA-INS-VOID-IND X(01) Indicates whether the policy is voided in MHN N-Not Vodied Y-Voided N A POLICYHOLDER INFORMATION
DMA-INS-MHN-ID X(13) The MHN ID of the policyholder if the policyholder is on Medicaid or Peachcare
Field Name Format Description /
Comments Populated on Input to ACS from CSE?*
Populated on output from ACS to CSE?*
DMA-INS-PH-LAST-NAME X(20) The last name of the
policyholder A A
DMA-INS-PH-MIDDLE-
NAME X(12) The middle name of the policyholder C C
DMA-INS-PH-FIRST-NAME X(15) The first name of the
policyholder A A
DMA-INS-PH-ADDR-STR1 X(25) The street address of
the policyholder A A
DMA-INS-PH-ADDR-STR2 X(25) The street address of
the policyholder C C
DMA-INS-PH-ADDR-CITY X(22) The city of the
policyholder A A
DMA-INS-PH-ADDR-ST X(02) The state of the
policyholder A A
DMA-INS-PH-ADDR-ZIP X(09) The zip code of the
policyholder A A
DMA-INS-PH-SSN 9(09) The SSN of the
policyholder A A
DMA-INS-PH-DOB X(08) The DOB of the
policyholder. Format CCYYMMDD
A A
DMA-INS-PH-EMP-NAME X(65) The employer of the
policyholder C C
DMA-INS-PH-EMP-ADDR-
STR1 X(25) The street address of the employer C C
DMA-INS-PH-EMP-ADDR-
STR2 X(25) The street address of the employer C C
DMA-INS-PH-EMP-ADDR-
CITY X(22) The city of the employer C C
DMA-INS-PH-EMP-ADDR-
ZIP X(09) The zip code of the employer C C
DMA-INS-PH-EMP-PHONE X(10) The phone number
of the employer C C
Absent Parent Information
This section contains the absent parent information from CSE.
ACS will pass back what was sent to them in the return file to CSE.
DMA-INS-AP-CSE-CLIENT-
ID 9(09) The CSE Client ID for the Absent Parent A A
DMA-INS-AP-LAST-NAME X(20) The last name of the
NCP A C
DMA-INS-AP-MIDDLE-
NAME X(12) The middle name of the NCP C C
DMA-INS-AP-FIRST-NAME X(15) The first name of the
NCP A C
DMA-INS-AP-ADDR-STR1 X(25) The street address of
the NCP A C
DMA-INS-AP-ADDR-STR2 X(25) The street address of
the NCP C C
DMA-INS-AP-ADDR-CITY X(22) The city of the NCP A C
DMA-INS-AP-ADDR-ST X(02) The state of the NCP A C
DMA-INS-AP-ADDR-ZIP X(09) The zip code of the
NCP A C
Field Name Format Description /
Comments Populated on Input to ACS from CSE?*
Populated on output from ACS to CSE?*
DMA-INS-AP-DOB X(08) The DOB of the NCP.
Format CCYYMMDD A C
DMA-INS-AP-EMP-NAME X(65) The employer of the
p NCP C C
DMA-INS-AP-EMP-ADDR-
STR1 X(25) The street address of the employer C C
DMA-INS-AP-EMP-ADDR-
STR2 X(25) The street address of the employer C C
DMA-INS-AP-EMP-ADDR-
CITY X(22) The city of the employer C C
DMA-INS-AP-EMP-ADDR-
ST X(02) The state of the employer C C
DMA-INS-AP-EMP-ADDR-
ZIP X(09) The zip code of the employer C C
DMA-INS-AP-EMP-PHONE X(10) The phone number
of the employer C C
Custodial Parent Information
This section contains the custodial parent information from CSE.
ACS will pass back what was sent to them in the return file to CSE.
DMA-INS-CP-CSE-CLIENT-
ID 9(09) The CSE Client ID for the custodial parent A A DMA-CP-LAST-NAME X(20) The last name of the
custodial parent A C
DMA-CP-MIDDLE-NAME X(01) The middle initial of
the custodial parent C C
DMA-CP-FIRST-NAME X(15) The first name of the
DMA-CP-ADDR-STR1 X(25) The street address of
the custodial parent A C
DMA-CP-ADDR-STR2 X(25) The street address of
the custodial parent C C
DMA-CP-ADDR-CITY X(22) The city of the
custodial parent A C
DMA-CP-ADDR-ST X(02) The state of the
custodial parent A C
DMA-CP-ADDR-ZIP X(09) The zip code of the
custodial parent A C
DMA-CP-SSN 9(09) The SSN of the
custodial parent A C
DMA-CP-DOB X(08) The DOB of the
custodial parent. Format CCYYMMDD
A C
DMA-CP-EMP-NAME X(65) The employer of the
custodial parent C C
DMA-CP-EMP-ADDR-STR1 X(25) The street address of
the employer C C
DMA-CP-EMP-ADDR-STR2 X(25) The street address of
the employer C C
DMA-CP-EMP-ADDR-CITY X(22) The city of the
employer C C
DMA-CP-EMP-ADDR-ST X(02) The state of the
employer C C
DMA-CP-EMP-ADDR-ZIP X(09) The zip code of the
employer C C
DMA-CP-EMP-PHONE X(10) The phone number
of the employer C C
Field Name Format Description /
Comments Populated on Input to ACS from CSE?*
Populated on output from ACS to CSE?*
OCCURS 18 TIMES
DMA-CHILD-LAST-NAME X(20) The last name of the
child covered A A
DMA-CHILD-MIDDLE-
NAME X(15) The middle name of the child covered C C
DMA-CHILD-FIRST-NAME X(15) The first name of the
child covered A A
DMA-INS-CHILD-CSE-
CLIENT-ID 9(09) The CSE Client ID for the child A A
DMA-CHILD-MHN-ID X(13) The MHN ID of the
child covered ? A
DMA-CHILD-DCH-IND X(01) Indicates whether the child is Medicaid, Peachcare or neither M – Medicaid P – Peachcare X- Former Medicaid Z- Former Peachcare N – neither N A
DMA-INS-DCH-IND-DT X(08) Date of Medicaid or Peachcare
information. Format CCYYMMDD
Will contain the most recent activity associated with the DCH indicator. If active, the effective date for coverage. If former, the date the services were terminated
DMA-INS-CHILD-EFF-DT X(08) Date coverage was effective for child. Format CCYYMMDD
A A
DMA-INS-CHILD-TERM-DT X(08) Date coverage was terminated for child. Format CCYYMMDD
A A
DMA-INS-CHILD-SSN 9(09) The SSN of the child A A
DMA-INS-CHILD-DOB X(08) The DOB of the child.
Format CCYYMMDD A A
DMA-INS-DCH-SOURCE X(01) Indicates whether the policyholder is CP, AP or unknown 1-NCP 2-CP 3-CP Spouse 4-NCP Spouse 5-Other 6-Unknown A A LEGEND: For Populated:
A = Always (will always contain a value on the file) C = Conditionally (populated if present in database) N = Never (never populated in file)
Object Status
Status Date Status Responsible Person
8/26/2008 3:45:25 PM Identified - New Sedgwick, Tammy 12/19/2008 12:10:43 AM Approved Demaray, Matt