FTX.008.301

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TMSIS Dataguide

Medicaid.gov

Version:

COST-SETTLEMENT-PERIOD-START-DATE

Data Element

DE Number

FTX301

System DE Number

FTX.008.301

File Name

FTX - FINANCIAL TRANSACTION

File Segment Number

File Segment Name

COST-SETTLEMENT-PAYMENT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances

Definition	The date representing the beginning of the cost settlement period. For example, if the cost settlement is for the first calendar quarter of the year then the Cost Settlement Period Start Date would be January 1 of that year and the Cost Settlement Period End Date would be March 31 of that year. Likewise, if the cost settlement is for the first calendar month of the year then the Cost Settlement Period Start Date would be January 1 of that year and the Cost Settlement Period End Date would be January 31 of that year.
Size	9(8)
FLF Start Position	665
FLF Stop Position	672
Segment Key Field Identifier	Not Applicable
Coding Requirements	1. The date must be a valid calendar date in the form "CCYYMMDD" 2. Value must be before or the same as the associated Cost Settlement Period End Date 3. Value of the CC component must be equal to "20" 4. 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-8293	If a financial transaction is from an FTX file, then the cost settlement period start date value reported must be a valid date of the form CCYYMMDD.
RULE-8653	If the Cost Settlement Payment Transactions segment is populated from a FTX file, then the COST-SETTLEMENT-PERIOD-START-DATE must be populated
RULE-8725	If a financial transaction is a non-void, and the PAYEE ID is populated on Cost Settlement Payment segment from the FTX file and the PAYEE ID type is either Sub-capitated network provider ID or State contracted FFS provider ID assigned by state, then the PAYEE ID value reported must be equal to a submitting state provider ID on a provider main attributes segment from a PRV file where the effective and end dates of the provider main attributes segment overlap with the cost settlement period start date on the financial transaction.
RULE-8734	If a financial transaction is a non-void, and the PAYEE ID is populated on Cost Settlement Payment segment from the FTX file and the PAYEE ID Type is State contracted FFS provider NPI, then the PAYEE ID value reported must be equal to a provider NPI on a provider identifier segment from a PRV file where the effective and end dates of the provider identifier segment overlap with the cost settlement period start date on the financial transaction.
RULE-8743	If a financial transaction is a non-void, and the payer ID is populated on Cost Settlement Payment segment from the FTX file and the payer id type is Sub-capitated network provider ID, then the payer ID value reported must be equal to a submitting state provider ID on a provider main attributes segment from a PRV file where the effective and end dates of the provider main attributes segment overlap with the cost settlement period start date on the financial transaction.
RULE-8758	If a financial transaction is a non-void, and the PAYEE ID is populated on Cost Settlement Payment segment from the FTX file and the PAYEE ID Type is Capitated plan ID, then the PAYEE ID value reported must be equal to a State Plan Identification Number on a managed care main segment from a MCR file where the managed care contract effective and end dates of the managed care main segment overlap with the cost settlement period start date on the financial transaction.
RULE-8764	If a financial transaction is a non-void, and the PAYER ID is populated on Cost Settlement Payment segment from the FTX file and the PAYER ID Type is Capitated plan ID, then the PAYER ID value reported must be equal to a State Plan Identification Number on a managed care main segment from a MCR file where the managed care contract effective and end dates of the managed care main segment overlap with the cost settlement period start date on the financial transaction.
RULE-8773	If a financial transaction is a non-void, and the PAYEE ID is populated on Cost Settlement Payment segment from the FTX file and the PAYEE ID Type is Beneficiary, then the PAYEE ID value reported must be equal to a MSIS Identification Number on a primary demographics eligibility segment from a ELG file where the primary demographic element effective and end dates of the primary demographics eligibility segment overlap with the cost settlement period start date on the financial transaction.
RULE-8782	If a financial transaction is a non-void, and the PAYEE ID is populated on Cost Settlement Payment segment from the FTX file and the PAYEE ID Type is Insurance carrier, then the PAYEE ID value reported must be equal to a Insurance Carrier ID Number on a TPL entity contact information segment from a TPL file where the TPL Entity Contact Information effective and end dates of the TPL entity contact information segment overlap with the cost settlement period start date on the financial transaction.

Measure ID	Measure Name
RULE-8758	% of records with a valid value for Payee ID (FTX00008) that do not have a corresponding MCR Managed Care Main segment for the same time period
RULE-8764	% of records with a valid value for Payer ID (FTX00008) that do not have a corresponding MCR Managed Care Main segment for the same time period
RULE-8653	% missing: COST-SETTLEMENT-PERIOD-START-DATE (FTX00008)

DE Number	System DE Number	DE Name	File Segment Number	File Segment Name

Published Date	Data Guide Version	Data Element	Action	Field	Before	After
03/14/2025	4.0.4	FTX.008.301	UPDATE	Definition	The date representing the beginning of the cost-settlement period. For example, if the cost-settlement is for the first calendar quarter of the year, then the cost settlement begin date would be March 1 of that year.	The date representing the beginning of the cost settlement period. For example, if the cost settlement is for the first calendar quarter of the year then the Cost Settlement Period Start Date would be January 1 of that year and the Cost Settlement Period End Date would be March 31 of that year. Likewise, if the cost settlement is for the first calendar month of the year then the Cost Settlement Period Start Date would be January 1 of that year and the Cost Settlement Period End Date would be January 31 of that year.
09/16/2024	4.0.0	FTX.008.301	UPDATE	File segment	None	74
09/16/2024	4.0.0	FTX.008.301	ADD	N/A		Created