FTX.003.072

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TMSIS Dataguide

Medicaid.gov

Version:

PAYMENT-AMOUNT

Data Element

DE Number

FTX072

System DE Number

FTX.003.072

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 dollar amount being paid to the payee.
Size	S9(11)V99
FLF Start Position	131
FLF Stop Position	143
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. Value must be between -99999999999.99 and 99999999999.99 2. Value must be expressed as a number with 2-digit precision (e.g. 100.50) 3. Mandatory

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

RULE ID	RULE Definition
RULE-8069	If a financial transaction is from an FTX file, then the payment amount value reported must be compatible with specified T-MSIS picture format: S9(11)V99.
RULE-8702	If the Insurance Premium Payment Transaction segment is populated from a FTX file, then the PAYMENT-AMOUNT must be populated

Measure ID	Measure Name
EXP-20-001-1	Sum of Payment or Recoupment Amount for other premium
EXP-20-002-2	Average Payment or Recoupment Amount for other premium
EXP-21-001-1	Sum of Payment or Recoupment Amount for other premium
EXP-21-002-2	Average Payment or Recoupment Amount for other premium
EXP-23-001-2	Sum of Payment or Recoupment Amount
EXP-23-002-1	Average absolute value of Payment or Recoupment Amount
EXP-25-001-2	Sum of Payment or Recoupment Amount
EXP-25-002-1	Average absolute value of Payment or Recoupment Amount
MCR-28-001-1	% of plan IDs with capitation payment ratios <0.9 or >1.1 (non-PCCM)
EXP-22-009-9	% of records with Payment or Recoupment Amount = $0 or missing
EXP-24-009-9	% of records with Payment or Recoupment Amount = $0 or missing
EXP-22P-009-9	% of records with Payment or Recoupment Amount = $0 or missing, by Plan ID
EXP-22R-009-9	% of Plan IDs over the threshold for EXP-22P-009-9 (% of records with Payment or Recoupment Amount = $0 or missing, by Plan ID)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name
FTX113	FTX.004.113	PAYMENT-AMOUNT	FTX00004	GROUP-INSURANCE-PREMIUM-PAYMENT

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
09/16/2024	4.0.0	FTX.003.072	UPDATE	File segment	None	69
09/16/2024	4.0.0	FTX.003.072	ADD	N/A		Created