Chiapas EDI 2012 Mapping Guide

(C) Copyright 2012 Chiapas EDI Technologies, Inc.

4010_820 4010 Payroll Deducted and Other Group Premium Payment for Insurance Products - Code:G0

ISA - GROUP HEADERS

LoopSegmentSegment NameChiapas Gate Mapping
OEISAISAInterchange Control Header
OEISAISA02No Authorization Information PresentOEISA_S01_ISA02_AUTH_NFO_OVL_NO_AUTH_NFO
OEISAISA02Additional Data IdentificationOEISA_S01_ISA02_AUTH_NFO_OVL_ADDL_ID
OEISAISA04No Security Information PresentOEISA_S01_ISA04_SEC_NFO_OVL_NO_SEC_NFO
OEISAISA04PasswordOEISA_S01_ISA04_SEC_NFO_OVL_PASSWD
OEISAISA06Dun and BrandstreetOEISA_S01_ISA06_SENDR_ID_OVL_DUNS_ID
OEISAISA06Duns Plus SuffixOEISA_S01_ISA06_SENDR_ID_OVL_DUNS_SUFFX_ID
OEISAISA06Health Industry NumberOEISA_S01_ISA06_SENDR_ID_OVL_HIN_ID
OEISAISA06Carrier Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA06_SENDR_ID_OVL_HCFA_CARR_ID
OEISAISA06Fiscal Intermediary Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA06_SENDR_ID_OVL_HCFA_FIIN_ID
OEISAISA06Medicare Provider and Supplier Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA06_SENDR_ID_OVL_HCFA_MEDCR_ID
OEISAISA06US Federal Tax Identification NumberOEISA_S01_ISA06_SENDR_ID_OVL_TAX_ID
OEISAISA06National Association of Insurance Commissioners Company CodeOEISA_S01_ISA06_SENDR_ID_OVL_NAIC_ID
OEISAISA06Mutually DefinedOEISA_S01_ISA06_SENDR_ID_OVL_MUTLY_DEFND_ID
OEISAISA08Dun and BrandstreetOEISA_S01_ISA08_RECVR_ID_OVL_DUNS_ID
OEISAISA08Duns Plus SuffixOEISA_S01_ISA08_RECVR_ID_OVL_DUNS_SUFFX_ID
OEISAISA08Health Industry NumberOEISA_S01_ISA08_RECVR_ID_OVL_HIN_ID
OEISAISA08Carrier Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA08_RECVR_ID_OVL_HCFA_CARR_ID
OEISAISA08Fiscal Intermediary Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA08_RECVR_ID_OVL_HCFA_FIIN_ID
OEISAISA08Medicare Provider and Supplier Identification Number as assigned by Health Care Financing AdministrationOEISA_S01_ISA08_RECVR_ID_OVL_HCFA_MEDCR_ID
OEISAISA08US Federal Tax Identification NumberOEISA_S01_ISA08_RECVR_ID_OVL_TAX_ID
OEISAISA08National Association of Insurance Commissioners Company CodeOEISA_S01_ISA08_RECVR_ID_OVL_NAIC_ID
OEISAISA08Mutually DefinedOEISA_S01_ISA08_RECVR_ID_OVL_MUTLY_DEFND_ID
OEISAISA09Interchange DateOEISA_S01_ISA09_DT
OEISAISA10Interchange TimeOEISA_S01_ISA10_TM
OEISAISA11Repetition SeparatorOEISA_S01_ISA11_REPTN_SEPRTR
OEISAISA12Interchang Control Version NumberOEISA_S01_ISA12_VERSN_NR
OEISAISA13Interchange Control NumberOEISA_S01_ISA13_ICN
OEISAISA14Acknowledgment RequestedOEISA_S01_ISA14_ACK_REQ
OEISAISA15Interchange Usage IndicatorOEISA_S01_ISA15_USG_IND
OEISAISA16Component Element SeparatorOEISA_S01_ISA16_SUBELE_SEP
OEISAIEAInterchange Control Trailer
OEISAIEA01Number of Included Functional GroupsOEISA_S03_IEA01_GS_CT
OEISAIEA02Interchange Control NumberOEISA_S03_IEA02_ICN

GSHDR - GROUP HEADER

LoopSegmentSegment NameChiapas Gate Mapping
GSHDRGSFunctional Group Header
GSHDRGS01Functional Identifier CodeGSHDR_S01_GS01_FUNCTL_ID_CD
GSHDRGS02Application Senders CodeGSHDR_S01_GS02_APP_SENDR_CD
GSHDRGS03Application Receivers CodeGSHDR_S01_GS03_APP_RECVR_CD
GSHDRGS04DateGSHDR_S01_GS04_DT
GSHDRGS05TimeGSHDR_S01_GS05_TM
GSHDRGS06Group Control NumberGSHDR_S01_GS06_GCN
GSHDRGS07Responsible Agency CodeGSHDR_S01_GS07_RESP_AGNCY_CD
GSHDRGEFunctional Group Trailer
GSHDRGE01Number of Transaction Sets IncludedGSHDR_S03_GE01_TS_CT
GSHDRGE02Group Control NumberGSHDR_S03_GE02_GCN

STHDR - TRANSACTION SET HEADER

LoopSegmentSegment NameChiapas Gate Mapping
STHDRST820 Header
STHDRST01Transaction Set Identifier CodeSTHDR_S01_ST01_TS_ID_CD
STHDRST02Transaction Set Control NumberSTHDR_S01_ST02_TS_CONTRL_NR
STHDRBPRFinancial Information
STHDRBPR02Payment Accompanies Remittance AdviceSTHDR_S02_BPR02_TOTL_PREM_PMT_AMT_OVL_PMT_ACMPNS_REMTNC_ADVC
STHDRBPR02Make Payment OnlySTHDR_S02_BPR02_TOTL_PREM_PMT_AMT_OVL_MAK_PMT_ONLY
STHDRBPR02Remittance Information OnlySTHDR_S02_BPR02_TOTL_PREM_PMT_AMT_OVL_REMTNC_NFO_ONLY
STHDRBPR02Prenotification of Future TransfersSTHDR_S02_BPR02_TOTL_PREM_PMT_AMT_OVL_PRENTFCTN_FUTR_XFERS
STHDRBPR02Split Payment and RemittanceSTHDR_S02_BPR02_TOTL_PREM_PMT_AMT_OVL_SPLIT_PMT_REMTNC
STHDRBPR02Handling Party’s Option to Split Payment andSTHDR_S02_BPR02_TOTL_PREM_PMT_AMT_OVL_PARTY_OPTN_TO_SPLIT_PMT
STHDRBPR03Credit or Debit Flag CodeSTHDR_S02_BPR03_CREDT_DEBT_FLAG_CD
STHDRBPR04Payment Method CodeSTHDR_S02_BPR04_PMT_METHD_CD
STHDRBPR05Payment Format CodeSTHDR_S02_BPR05_PMT_FORMT_CD
STHDRBPR06Depository Financial Institution (DFI)STHDR_S02_BPR06_DFI
STHDRBPR07Originating Depository Financial Institution (DFI)STHDR_S02_BPR07_ORGNTNG_DFI
STHDRBPR09Agency Location Code (ALC)STHDR_S02_BPR09_SENDR_BANK_ACNT_NR_OVL_ALC
STHDRBPR09Demand DepositSTHDR_S02_BPR09_SENDR_BANK_ACNT_NR_OVL_DEMND_DEPST
STHDRBPR10Originating Company IdentifierSTHDR_S02_BPR10_ORGNTNG_CO_ID
STHDRBPR11Originating Company Supplemental CodeSTHDR_S02_BPR11_ORGNTNG_CO_SUPP_CD
STHDRBPR12Depository Financial Institution (DFI)STHDR_S02_BPR12_DFI
STHDRBPR13Receiving Depository Financial Institution (DFI)STHDR_S02_BPR13_RECVNG_DFI
STHDRBPR15Demand DepositSTHDR_S02_BPR15_RECVR_BANK_ACNT_NR_OVL_DEMND_DEPST
STHDRBPR15SavingsSTHDR_S02_BPR15_RECVR_BANK_ACNT_NR_OVL_SAVNGS
STHDRBPR16Check Issue or EFT Effective DateSTHDR_S02_BPR16_CHK_IS_EFT_EFF_DT
STHDRTRNReassociation Key
STHDRTRN01Trace Type CodeSTHDR_S03_TRN01_TRAC_TYPE_CD
STHDRTRN02Check or EFT Trace NumberSTHDR_S03_TRN02_CHK_EFT_TRAC_NR
STHDRTRN03Originating Company IdentifierSTHDR_S03_TRN03_ORGNTNG_CO_ID
STHDRTRN04Originating Company Supplemental CodeSTHDR_S03_TRN04_ORGNTNG_CO_SUPP_CD
STHDRCURNon-US Dollars Currency
STHDRCUR01Entity Identifier CodeSTHDR_S04_CUR01_ENTY_ID_CD
STHDRCUR02Currency CodeSTHDR_S04_CUR02_CURNCY_CD
STHDRCUR03Exchange RateSTHDR_S04_CUR03_EXCHNG_RAT
STHDRREFPremium Receivers Identification Key
STHDRREF02Master Account NumberSTHDR_S05_REF02_PREM_RECVR_REF_ID_OVL_MASTR_ACNT_NR
STHDRREF02Plan NumberSTHDR_S05_REF02_PREM_RECVR_REF_ID_OVL_PLAN_NR
STHDRREF02Consolidated Invoice NumberSTHDR_S05_REF02_PREM_RECVR_REF_ID_OVL_CONSLDTD_INVC_NR
STHDRREF02Master Policy NumberSTHDR_S05_REF02_PREM_RECVR_REF_ID_OVL_MASTR_POLCY_NR
STHDRREF02Schedule Reference NumberSTHDR_S05_REF02_PREM_RECVR_REF_ID_OVL_SCHEDL_REF_NR
STHDRDTMProcess Date
STHDRDTM02ProcessSTHDR_S06_DTM02_PAYR_PROCS_DT_OVL_PROCS
STHDRDTMDelivery Date
STHDRDTM02DeliveredSTHDR_S07_DTM02_PREM_DELVRY_DT_OVL_DELVRD
STHDRDTMCoverage Period
STHDRDTM01Date Time QualifierSTHDR_S08_DTM01_DT_TM_QUAL
STHDRDTM06Range of Dates Expressed in Format CCYYMMDD- CCYYMMDDSTHDR_S08_DTM06_COVG_PERD_OVL_RANG_DT_CCYYMMDD
STHDRSE820 Trailer
STHDRSE01Transaction Segment CountSTHDR_S13_SE01_SEG_CT
STHDRSE02Transaction Set Control NumberSTHDR_S13_SE02_TCN

1000A - PREMIUM RECEIVERS NAME

LoopSegmentSegment NameChiapas Gate Mapping
L1000AN1Premium Receiver’s Name
L1000AN102Information Receiver Last or Organization NameL1000A_S01_N102_NFO_RECVR_LAST_ORG_NM
L1000AN104D-U-N-S Number, Dun and BradstreetL1000A_S01_N104_RECVR_ID_OVL_DUNS_NR_DUN_BRADSTRT
L1000AN104D-U-N-S+4, D-U-N-S Number with Four Character SuffixL1000A_S01_N104_RECVR_ID_OVL_DUNS4_DUNS_NR_WITH_4CHAR_SUFX
L1000AN104Insurance Company Assigned Identification NumberL1000A_S01_N104_RECVR_ID_OVL_INS_CO_ASGND_ID_NR
L1000AN104Federal Taxpayer’s Identification NumberL1000A_S01_N104_RECVR_ID_OVL_FED_TAX_ID_NR
L1000AN104Health Care Financing Administration NationalL1000A_S01_N104_RECVR_ID_OVL_HCFA_NATNL
L1000AN2Premium Receiver Additional Name
L1000AN201Receiver Additional NameL1000A_S02_N201_ADDL_NM
L1000AN3Premium Receiver’s Address
L1000AN301Receiver Address LineL1000A_S03_N301_ADRS_LIN
L1000AN302Receiver Address LineL1000A_S03_N302_ADRS_LIN
L1000AN4Premium Receiver’s City, State, Zip
L1000AN401Information Receiver City NameL1000A_S04_N401_NFO_RECVR_CITY_NM
L1000AN402Information Receiver State CodeL1000A_S04_N402_NFO_RECVR_STAT_CD
L1000AN403Information Receiver Postal Zone or ZIP CodeL1000A_S04_N403_NFO_RECVR_POSTL_ZON_ZIP_CD
L1000AN404Country CodeL1000A_S04_N404_CNTRY_CD

1000B - PREMIUM PAYERS NAME

LoopSegmentSegment NameChiapas Gate Mapping
L1000BN1Premium Payer’s Name
L1000BN102Premium Payer NameL1000B_S01_N102_PAYR_NM
L1000BN104D-U-N-S Number, Dun and BradstreetL1000B_S01_N104_PAYR_ID_OVL_DUNS_NR_DUN_BRADSTRT
L1000BN104D-U-N-S+4, D-U-N-S Number with Four Character SuffixL1000B_S01_N104_PAYR_ID_OVL_DUNS4_DUNS_NR_WITH_4CHAR_SUFX
L1000BN104Employer’s Identification NumberL1000B_S01_N104_PAYR_ID_OVL_EMPLYR_ID_NR
L1000BN104State or Province Assigned NumberL1000B_S01_N104_PAYR_ID_OVL_STAT_PROVNC_ASGND_NR
L1000BN104Insurance Company Assigned Identification NumberL1000B_S01_N104_PAYR_ID_OVL_INS_CO_ASGND_ID_NR
L1000BN104Federal Taxpayer’s Identification NumberL1000B_S01_N104_PAYR_ID_OVL_FED_TAX_ID_NR
L1000BN104Payor IdentificationL1000B_S01_N104_PAYR_ID_OVL_PAYR_ID
L1000BN2Premium Payer Additional Name
L1000BN201Premium Payer Additional NameL1000B_S02_N201_PREM_PAYR_ADDL_NM
L1000BN3Premium Payer’s Address
L1000BN301Premium Payer Address LineL1000B_S03_N301_PREM_PAYR_ADRS_LIN
L1000BN302Premium Payer Address LineL1000B_S03_N302_PREM_PAYR_ADRS_LIN
L1000BN4Premium Payer’s City, State, Zip
L1000BN401Premium Payer City NameL1000B_S04_N401_PREM_PAYR_CITY_NM
L1000BN402Premium Payer State CodeL1000B_S04_N402_PREM_PAYR_STAT_CD
L1000BN403Premium Payer Postal Zone or ZIP CodeL1000B_S04_N403_POSTL_ZON_ZIP_CD
L1000BN404Country CodeL1000B_S04_N404_CNTRY_CD
L1000BPERPremium Payer’s Administrative Contact
L1000BPER01Contact Function CodeL1000B_S05_PER01_CONTCT_FUNCTN_CD
L1000BPER02Premium Payer Contact NameL1000B_S05_PER02_PREM_PAYR_CONTCT_NM
L1000BPER04Electronic MailL1000B_S05_PER04_COMM_NR_OVL_EMAIL
L1000BPER04FacsimileL1000B_S05_PER04_COMM_NR_OVL_FACSML
L1000BPER04TelephoneL1000B_S05_PER04_COMM_NR_OVL_TELPHN
L1000BPER06Telephone ExtensionL1000B_S05_PER06_COMM_NR_OVL_PHN_EXTNS
L1000BPER06FacsimileL1000B_S05_PER06_COMM_NR_OVL_FACSML
L1000BPER06TelephoneL1000B_S05_PER06_COMM_NR_OVL_TELPHN
L1000BPER08Electronic MailL1000B_S05_PER08_COMM_NR_OVL_EMAIL
L1000BPER08Telephone ExtensionL1000B_S05_PER08_COMM_NR_OVL_PHN_EXTNS
L1000BPER08FacsimileL1000B_S05_PER08_COMM_NR_OVL_FACSML
L1000BPER08TelephoneL1000B_S05_PER08_COMM_NR_OVL_TELPHN

2000A - ORGANIZATION SUMMARY REMITTANCE

LoopSegmentSegment NameChiapas Gate Mapping
L2000AENTOrganization Summary Remittance
L2000AENT01Assigned NumberL2000A_S01_ENT01_ASGND_NR
L2000AENT04D-U-N-S Number, Dun and BradstreetL2000A_S01_ENT04_ID_CD_OVL_DUNS_NR_DUN_BRADSTRT
L2000AENT04D-U-N-S+4, D-U-N-S Number with Four Character SuffixL2000A_S01_ENT04_ID_CD_OVL_DUNS4_DUNS_NR_WITH_4CHAR_SUFX
L2000AENT04Federal Taxpayer’s Identification NumberL2000A_S01_ENT04_ID_CD_OVL_FED_TAX_ID_NR

2300A - ORGANIZATION SUMMARY REMITTANCE DETAIL

LoopSegmentSegment NameChiapas Gate Mapping
L2300ARMROrganization Summary Remittance Detail
L2300ARMR02Account NumberL2300A_S01_RMR02_CONTRCT_INVC_ACNT_GROUP_POLCY_OVL_ACNT_NR
L2300ARMR02Group or Policy NumberL2300A_S01_RMR02_CONTRCT_INVC_ACNT_GROUP_POLCY_OVL_GRP_POLCY_NR
L2300ARMR02Contract NumberL2300A_S01_RMR02_CONTRCT_INVC_ACNT_GROUP_POLCY_OVL_CONTRCT_NR
L2300ARMR02Invoice NumberL2300A_S01_RMR02_CONTRCT_INVC_ACNT_GROUP_POLCY_OVL_INVC_NR
L2300ARMR04Payment in AdvanceL2300A_S01_RMR04_DETL_PREM_PMT_AMT_OVL_PMT_IN_ADVNC
L2300ARMR04Pay ItemL2300A_S01_RMR04_DETL_PREM_PMT_AMT_OVL_PAY_ITM
L2300ARMR04Payment on AccountL2300A_S01_RMR04_DETL_PREM_PMT_AMT_OVL_PMT_ON_ACNT
L2300ARMR04Partial PaymentL2300A_S01_RMR04_DETL_PREM_PMT_AMT_OVL_PARTL_PMT
L2300ARMR05Billed Premium AmountL2300A_S01_RMR05_BILD_PREM_AMT

2310A - SUMMARY LINE ITEM

LoopSegmentSegment NameChiapas Gate Mapping
L2310AIT1Summary Line Item
L2310AIT101Line Item Control NumberL2310A_S01_IT101_LIN_ITM_CONTRL_NR

2315A - MEMBER COUNT

LoopSegmentSegment NameChiapas Gate Mapping
L2315ASLNMember Count
L2315ASLN01Line Item Control NumberL2315A_S01_SLN01_LIN_ITM_CONTRL_NR
L2315ASLN03Information Only IndicatorL2315A_S01_SLN03_NFO_ONLY_IND
L2315ASLN04Head CountL2315A_S01_SLN04_HEAD_CT
L2315ASLN05-01Unit or Basis for Measurement CodeL2315A_S01_SLN05_01_UN_BAS_MEASRMNT_CD

2320A - ORGANIZATION SUMMARY REMITTANCE LEVEL ADJUSTMENT

LoopSegmentSegment NameChiapas Gate Mapping
L2320AADXOrganization Summary Remittance Level Adjustment
L2320AADX01Adjustment AmountL2320A_S01_ADX01_ADJ_AMT
L2320AADX02Adjustment Reason CodeL2320A_S01_ADX02_ADJ_RSN_CD

2000B - INDIVIDUAL REMITTANCE

LoopSegmentSegment NameChiapas Gate Mapping
L2000BENTIndividual Remittance
L2000BENT01Assigned NumberL2000B_S01_ENT01_ASGND_NR
L2000BENT04Social Security NumberL2000B_S01_ENT04_RECVR_INDVDL_ID_OVL_SSN
L2000BENT04Employee Identification NumberL2000B_S01_ENT04_RECVR_INDVDL_ID_OVL_EMPLY_ID_NR
L2000BENT04Mutually DefinedL2000B_S01_ENT04_RECVR_INDVDL_ID_OVL_MUTLY_DEFND

2100B - INDIVIDUAL NAME

LoopSegmentSegment NameChiapas Gate Mapping
L2100BNM1Individual Name
L2100BNM102Entity Type QualifierL2100B_S01_NM102_ENTY_TYPE_QUAL
L2100BNM103Individual Last NameL2100B_S01_NM103_INDVDL_LNAME
L2100BNM104Individual First NameL2100B_S01_NM104_INDVDL_FNAME
L2100BNM105Individual Middle NameL2100B_S01_NM105_INDVDL_MNAME
L2100BNM106Individual Name PrefixL2100B_S01_NM106_NM_PREFX
L2100BNM107Individual Name SuffixL2100B_S01_NM107_NM_SUFX
L2100BNM109Social Security NumberL2100B_S01_NM109_INDVDL_ID_OVL_SSN
L2100BNM109Employee Identification NumberL2100B_S01_NM109_INDVDL_ID_OVL_EMPLY_ID_NR
L2100BNM109Insured’s Unique Identification NumberL2100B_S01_NM109_INDVDL_ID_OVL_INSRD_UNQ_ID_NR

2300B - INDIVIDUAL PREMIUM REMITTANCE DETAIL

LoopSegmentSegment NameChiapas Gate Mapping
L2300BRMRIndividual Premium Remittance Detail
L2300BRMR02Account NumberL2300B_S01_RMR02_INS_REMTNC_REF_NR_OVL_ACNT_NR
L2300BRMR02Pension ContractL2300B_S01_RMR02_INS_REMTNC_REF_NR_OVL_PENSN_CONTRCT
L2300BRMR02Health Insurance Policy NumberL2300B_S01_RMR02_INS_REMTNC_REF_NR_OVL_HEALTH_INS_POLCY_NR
L2300BRMR02Life Insurance Policy NumberL2300B_S01_RMR02_INS_REMTNC_REF_NR_OVL_LIF_INS_POLCY_NR
L2300BRMR02Contract NumberL2300B_S01_RMR02_INS_REMTNC_REF_NR_OVL_CONTRCT_NR
L2300BRMR02Insurance Certificate NumberL2300B_S01_RMR02_INS_REMTNC_REF_NR_OVL_INS_CERT_NR
L2300BRMR02Insurance Policy NumberL2300B_S01_RMR02_INS_REMTNC_REF_NR_OVL_INS_POLCY_NR
L2300BRMR02Invoice NumberL2300B_S01_RMR02_INS_REMTNC_REF_NR_OVL_INVC_NR
L2300BRMR02CertificationL2300B_S01_RMR02_INS_REMTNC_REF_NR_OVL_CERT
L2300BRMR04Pay ItemL2300B_S01_RMR04_DETL_PREM_PMT_AMT_OVL_PAY_ITM
L2300BRMR04Partial PaymentL2300B_S01_RMR04_DETL_PREM_PMT_AMT_OVL_PARTL_PMT
L2300BRMR05Billed Premium AmountL2300B_S01_RMR05_BILD_PREM_AMT
L2300BDTMIndividual Coverage Period
L2300BDTM01Date Time QualifierL2300B_S02_DTM01_DT_TM_QUAL
L2300BDTM06Range of Dates Expressed in Format CCYYMMDD- CCYYMMDDL2300B_S02_DTM06_COVG_PERD_OVL_RANG_DT_CCYYMMDD

2320B - INDIVIDUAL PREMIUM ADJUSTMENT

LoopSegmentSegment NameChiapas Gate Mapping
L2320BADXIndividual Premium Adjustment
L2320BADX01Adjustment AmountL2320B_S01_ADX01_ADJ_AMT
L2320BADX02Adjustment Reason CodeL2320B_S01_ADX02_ADJ_RSN_CD