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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

RULE-7350

Validation Rule
Last updated

No Updates

Tier 2.0
Tier Description Relational error
Error Category E2002
Error Category Message Values inconsistently specified (single record type, multiple records)
Rule Type One Record Type (Multi Record)
File Segment Number PRV00007
Data Element Name PROV-MEDICAID-ENROLLMENT.STATE-PLAN-ENROLLMENT
Validation Logic , when records are partitioned into a group where PROV-MEDICAID-ENROLLMENT.STATE-PLAN-ENROLLMENT equals '3', and another group where PROV-MEDICAID-ENROLLMENT.STATE-PLAN-ENROLLMENT is equal to one of the following: '1', '2' then,'PROV-MEDICAID-ENROLLMENT.STATE-SUBMITTED-SEGMENT-EFFECTIVE-PERIOD-START-DATE and PROV-MEDICAID-ENROLLMENT.STATE-SUBMITTED-SEGMENT-EFFECTIVE-PERIOD-END-DATE from the first partition are non-overlapping with PROV-MEDICAID-ENROLLMENT.STATE-SUBMITTED-SEGMENT-EFFECTIVE-PERIOD-START-DATE and PROV-MEDICAID-ENROLLMENT.STATE-SUBMITTED-SEGMENT-EFFECTIVE-PERIOD-END-DATE from the second partition'
Rule Definition If the business key fields match on more than one provider medicaid enrollment segment in a PRV file, then the segment effective and end date values reported must not overlap.
Denominator Logic # of PROV-MEDICAID-ENROLLMENT segments with the distinct combination of SUBMITTING-STATE, SUBMITTING-STATE-PROV-ID, PROV-MEDICAID-ENROLLMENT-STATUS-CODE, and STATE-PLAN-ENROLLMENT equals '3' and with same distinct combination of SUBMITTING-STATE, SUBMITTING-STATE-PROV-ID, PROV-MEDICAID-ENROLLMENT-STATUS-CODE and STATE-PLAN-ENROLLMENT is equal to one of the following: '1', '2'