FTX.003.071

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TMSIS Dataguide

Medicaid.gov

Version:

PAYMENT-OR-RECOUPMENT-DATE

Data Element

DE Number

FTX071

System DE Number

FTX.003.071

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

File Segment Name

INDIVIDUAL-HEALTH-INSURANCE-PREMIUM-PAYMENT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The date that the payment was executed by the payer.
Size	9(8)
FLF Start Position	123
FLF Stop Position	130
Segment Key Field Identifier	5
Coding Requirements	1. The date must be a valid calendar date in the form "CCYYMMDD" 2. Mandatory 3. Value of the CC component must be equal to "20"

Valid Value Code Set	Valid Value Code	Valid Value Name	Valid Value Description	Effective Start Date	Effective End Date

RULE ID	RULE Definition
RULE-8068	If a financial transaction is from an FTX file, then the payment or recoupment date value reported must be a valid date of the form CCYYMMDD.
RULE-8639	If the Insurance Premium Payment Transaction segment is populated from a FTX file, then the PAYMENT-OR-RECOUPMENT-DATE must be populated
RULE-8711	If a financial transaction is from an FTX file Individual Health Insurance Premium Payment segment, then submitting state, original ICN, adjustment ICN, payment or recoupemnt date, and adjustment indicator values reported must be unique across all financial transactions in Individual Health Insurance Premium Payment segment.

Measure ID	Measure Name
RULE-8639	% of records missing PAYMENT-OR-RECOUPMENT-DATE

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
FTX024	FTX.002.024	PAYMENT-OR-RECOUPMENT-DATE	FTX00002	INDIVIDUAL-CAPITATION-PMPM
FTX156	FTX.005.156	PAYMENT-OR-RECOUPMENT-DATE	FTX00005	COST-SHARING-OFFSET
FTX199	FTX.006.199	PAYMENT-OR-RECOUPMENT-DATE	FTX00006	VALUE-BASED-PAYMENT
FTX243	FTX.007.243	PAYMENT-OR-RECOUPMENT-DATE	FTX00007	STATE-DIRECTED-PAYMENT-SEPARATE-PAYMENT-TERM
FTX286	FTX.008.286	PAYMENT-OR-RECOUPMENT-DATE	FTX00008	COST-SETTLEMENT-PAYMENT
FTX325	FTX.009.325	PAYMENT-OR-RECOUPMENT-DATE	FTX00009	FQHC-WRAP-PAYMENT
FTX364	FTX.095.364	PAYMENT-OR-RECOUPMENT-DATE	FTX00095	MISCELLANEOUS-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
03/14/2025	4.0.4	FTX.003.071	UPDATE	Definition	The date that the payment or recoupment was executed by the payer.	The date that the payment was executed by the payer.
09/16/2024	4.0.0	FTX.003.071	UPDATE	File segment	None	69
09/16/2024	4.0.0	FTX.003.071	ADD	N/A		Created