Media Requirements. Xxxx Xxxxxxxxxx Xxxxxx Xxxxxxx Date Revision Name o Name “Media Requirements" replaced with “Media Requirements / Encounter Claims Files Submission Requirements” o Added clarity to segments Manual Override File, Secure FTP Server, Sending Encounter Data, Receiving Error Reports. o CMS Internet Policy was removed. o Removed Segment “Monthly Financial Report” o Removed “Care Management Provider” file • Section 7 Standard Data Values: Reviewed and confirmed CMS value sets; updated CMS Place of Service Telehealth description; added clarity to Table D table name; for Table G, allow use of 00 value if Servicing Provider Type is not listed, provided additional guidance / links for choosing appropriate Unit of Measure (Table O). • Section 8.0 Quantity and Quality Edits, Reasonability and Validity Checks o Added expectation that fields must be valid as well as complete. o MassHealth adding checks for gaps in fields “Diagnosis Code” and “Surgical Procedure Code” sequence. o MassHealth clarification for validations for fields “Void Reason Code”, “Diagnosis code(s)”, “Servicing Provider Specialty”, “Bundle Indicator”, “Bundle Claim Number”, and “Bundle Claim Suffix”. o Enhanced readability and description consistency • Section 9.0 Appendices / Member File / Member Enrollment File Specifications o Removed references to Care Management file o Added completeness validity expectations for Race, Language and Ethnicity and Entity PIDSL. o Revised validation language for consistency o Revised headers for Table of Contents clarity • Standardized terminology throughout for consistency and readability • Updated MCE Names in “Org. Code” fields in all applicable sections. • All references to “PCC Internal Provider ID” changed to match “PCC Provider ID” for consistency, including in Revision History. • Added formatting and minor language changes throughout to improve readability • Updated language to reflect ICD10 and HIPAA EDI use cases 05/03/2019 RENAMED: • Field #232 • old name - “FILLER” • new name - “Provider Payment” Xxxx Xxxxxxxxxx 03/19/2019 Removed all the mentioning of potentially duplicate claims Xxxx Xxxxxxxxxx
Appears in 15 contracts
Samples: www.mass.gov, www.mass.gov, www.mass.gov
