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TMSIS Dataguide Medicaid.gov

Version:

4.0.20

RULE-3060

Validation Rule
Last updated

Tier 3.0
Tier Description Relational error
Error Category E3001
Error Category Message Missing corresponding record (2 record types, multi file) (ex. missing eligibility record for claim header)
Rule Type Child Parent Rule
File Segment Number ELG00002
Data Element Name TPL-MEDICAID-ELIGIBLE-PERSON-MAIN.SUBMITTING-STATE • TPL-MEDICAID-ELIGIBLE-PERSON-MAIN.MSIS-IDENTIFICATION-NUM
Validation Logic record TPL-MEDICAID-ELIGIBLE-PERSON-MAIN has corresponding parent record PRIMARY-DEMOGRAPHICS-ELIGIBILITY
Rule Definition All TPL medicaid eligible person main segments must have a corresponding primary demographics eligibility segment where the TPL medicaid eligible person main effective and end dates are within the primary demographics eligibility effective and end dates. Note: Primary demographics eligibility dates can be consecutive or overlapping.
Denominator Logic # of TPL-MEDICAID-ELIGIBLE-PERSON-MAIN segments