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TMSIS Dataguide Medicaid.gov

Version:

3.39.0

RULE-8533

Validation Rule
Last updated

No Updates

Tier 1.1
Tier Description Value Error
Error Category E1103
Error Category Message Value not in specified valid value set
Rule Type Valid Value
File Segment Number FTX00009
Data Element Name FQHC-WRAP-PAYMENT.PAYEE-MCR-PLAN-TYPE
Validation Logic 'If the PAYEE-MCR-PLAN-TYPE field is populated, the value must be contained in the set of valid values with id: 'MANAGED-CARE-PLAN-TYPE' and (if FQHC-WRAP-PAYMENT.WRAP-PERIOD-END-DATE is non-null then FQHC-WRAP-PAYMENT.WRAP-PERIOD-END-DATE >= Valid Values Effective-Date and FQHC-WRAP-PAYMENT.WRAP-PERIOD-END-DATE <= Valid Values End-Date)'
Rule Definition If the payee managed care plan type is populated on the FQHC Wrap Payment Transaction from a FTX file, then the payee managed care plan type reported must be found in the list of valid values.
Denominator Logic # of FTX FQHC Wrap Payment Transactions with FQHC-WRAP-PAYMENT.PAYEE-MCR-PLAN-TYPE equal to a valid, non-null value