Chiapas EDI 2012 Mapping Guide

(C) Copyright 2012 Chiapas EDI Technologies, Inc.

4010_834 4010 Benefit Enrollment and Maintenance - Code:H0

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
STHDRSTTransaction Set Header
STHDRST01Transaction Set Identifier CodeSTHDR_S01_ST01_ID_CD
STHDRST02Transaction Set Control NumberSTHDR_S01_ST02_CONTRL_NR
STHDRBGNBeginning Segment
STHDRBGN01Transaction Set Purpose CodeSTHDR_S02_BGN01_TS_PURPS_CD
STHDRBGN02Transaction Set Identifier CodeSTHDR_S02_BGN02_TS_ID_CD
STHDRBGN03Transaction Set Creation DateSTHDR_S02_BGN03_TS_CREATN_DT
STHDRBGN04Transaction Set Creation TimeSTHDR_S02_BGN04_TS_CREATN_TIM
STHDRBGN05Time Zone CodeSTHDR_S02_BGN05_TIM_ZON_CD
STHDRBGN06Transaction Set Identifier CodeSTHDR_S02_BGN06_TS_ID_CD
STHDRBGN08Action CodeSTHDR_S02_BGN08_ACTN_CD
STHDRREFTransaction Set Policy Number
STHDRREF02Master Policy NumberSTHDR_S03_REF02_MASTR_POLCY_NR_OVL_MASTR_POLCY_NR
STHDRDTPFile Effective Date
STHDRDTP03Effective (D8)STHDR_S04_DTP03_DT_TM_PERD_OVL_EFF_D8
STHDRDTP03Maintenance Effective (D8)STHDR_S04_DTP03_DT_TM_PERD_OVL_MAINTNC_EFF_D8
STHDRDTP03Enrollment (D8)STHDR_S04_DTP03_DT_TM_PERD_OVL_ENRLMNT_D8
STHDRDTP03Payment Commencement (D8)STHDR_S04_DTP03_DT_TM_PERD_OVL_PMT_COMNCMNT_D8
STHDRSETransaction Set Trailer
STHDRSE01Transaction Segment CountSTHDR_S09_SE01_SEG_CT
STHDRSE02Transaction Set Control NumberSTHDR_S09_SE02_TCN

1000A - SPONSOR NAME

LoopSegmentSegment NameChiapas Gate Mapping
L1000AN1Sponsor Name
L1000AN102Plan Sponsor NameL1000A_S01_N102_PLAN_SPONSR_NM
L1000AN104Federal Taxpayer’s Identification NumberL1000A_S01_N104_SPONSR_ID_OVL_FED_TAX_ID_NR
L1000AN104Mutually DefinedL1000A_S01_N104_SPONSR_ID_OVL_MUTLY_DEFND

1000B - PAYER

LoopSegmentSegment NameChiapas Gate Mapping
L1000BN1Payer
L1000BN102Insurer NameL1000B_S01_N102_INSR_NM
L1000BN104Federal Taxpayer’s Identification NumberL1000B_S01_N104_INSR_ID_CD_OVL_FED_TAX_ID_NR
L1000BN104Health Care Financing Administration National PlanIDL1000B_S01_N104_INSR_ID_CD_OVL_HCFA_NATNL_PLAND

1000C - TPA/BROKER NAME

LoopSegmentSegment NameChiapas Gate Mapping
1000CQualified Loop
L1000CBroker or Sales OfficeL1000C_BO
L1000CThird Party Administrator (TPA)L1000C_TV
L1000CN1TPA/Broker Name
L1000CN102TPA or Broker NameL1000C_XX_S01_N102_BROKR_NM
L1000CN104Code assigned by the organization that is theL1000C_XX_S01_N104_TPA_BROKR_ID_CD_OVL_CD_ASGND_DESTNTN_ORG
L1000CN104Federal Taxpayer’s Identification NumberL1000C_XX_S01_N104_TPA_BROKR_ID_CD_OVL_FED_TAX_ID_NR
L1000CN104Health Care Financing Administration National PlanIDL1000C_XX_S01_N104_TPA_BROKR_ID_CD_OVL_HCFA_NATNL_PLAND

1100C - TPA/BROKER ACCOUNT INFORMATION

LoopSegmentSegment NameChiapas Gate Mapping
L1100CACTTPA/Broker Account Information
L1100CACT01TPA or Broker Account NumberL1100C_S01_ACT01_TPA_BROKR_ACNT_NR
L1100CACT06TPA or Broker Account NumberL1100C_S01_ACT06_TPA_BROKR_ACNT_NR

2000 - MEMBER LEVEL DETAIL

LoopSegmentSegment NameChiapas Gate Mapping
L2000INSMember Level Detail
L2000INS01Insured IndicatorL2000_S01_INS01_INSRD_IND
L2000INS02Individual Relationship CodeL2000_S01_INS02_INDVDL_REL_CD
L2000INS03Maintenance Type CodeL2000_S01_INS03_MAINTNC_TYPE_CD
L2000INS04Maintenance Reason CodeL2000_S01_INS04_MAINTNC_RSN_CD
L2000INS05Benefit Status CodeL2000_S01_INS05_BENFT_STATS_CD
L2000INS06Medicare Plan CodeL2000_S01_INS06_MEDCR_PLAN_CD
L2000INS07Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualified BeneficiaryL2000_S01_INS07_COBRA_QUALFD_BENFCRY
L2000INS08Employment Status CodeL2000_S01_INS08_EMPLYMNT_STATS_CD
L2000INS09Student Status CodeL2000_S01_INS09_STUDNT_STATS_CD
L2000INS10Handicap IndicatorL2000_S01_INS10_HANDCP_IND
L2000INS12Date Expressed in Format CCYYMMDDL2000_S01_INS12_INSRD_INDVDL_DEATH_DT_OVL_DT_CCYYMMDD
L2000INS17Birth Sequence NumberL2000_S01_INS17_BIRTH_SEQNC_NR
L2000REFSubscriber Number
L2000REF02Subscriber NumberL2000_S02_REF02_SUB_ID_OVL_SUB_NR
L2000REFMember Policy Number
L2000REF02Group or Policy NumberL2000_S03_REF02_INSRD_GRP_POLCY_NR_OVL_GRP_POLCY_NR
L2000REFMember Identification Number
L2000REF02Client Reporting CategoryL2000_S04_REF02_SUB_SUPP_ID_OVL_CLIENT_REPRTNG_CATGRY
L2000REF02Client NumberL2000_S04_REF02_SUB_SUPP_ID_OVL_CLIENT_NR
L2000REF02Case NumberL2000_S04_REF02_SUB_SUPP_ID_OVL_CAS_NR
L2000REF02Department/Agency NumberL2000_S04_REF02_SUB_SUPP_ID_OVL_DEPRTMNT_GNCY_NR
L2000REF02Health Insurance Claim (HIC) NumberL2000_S04_REF02_SUB_SUPP_ID_OVL_HIC_NR
L2000REF02Prior Identifier NumberL2000_S04_REF02_SUB_SUPP_ID_OVL_PRI_ID_NR
L2000REF02Mutually DefinedL2000_S04_REF02_SUB_SUPP_ID_OVL_MUTLY_DEFND
L2000REFPrior Coverage Months
L2000REF02Unit NumberL2000_S05_REF02_PRI_COVG_MONTH_CT_OVL_UNT_NR
L2000DTPMember Level Dates
L2000DTP03Retirement (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_RETRMNT_D8
L2000DTP03Return to Work (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_RETRN_TO_WORK_D8
L2000DTP03Date Last Worked (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_DAT_LAST_WORKD_D8
L2000DTP03Enrollment Signature Date (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_ENRLMNT_SIGNTR_DT_D8
L2000DTP03Consolidated Omnibus Budget Reconciliation Act (COBRA) Qualifying Event (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_COBRA_QUAL_EVNT_D8
L2000DTP03Maintenance Effective (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_MAINTNC_EFF_D8
L2000DTP03Employment Begin (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_EMPLYMNT_BEGN_D8
L2000DTP03Employment End (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_EMPLYMNT_END_D8
L2000DTP03Medicare Begin (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_MEDCR_BEGN_D8
L2000DTP03Medicare End (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_MEDCR_END_D8
L2000DTP03Consolidated Omnibus Budget Reconciliation Act (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_COBRA_D8
L2000DTP03Consolidated Omnibus Budget Reconciliation Act (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_COBRA_D8
L2000DTP03Education Begin (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_EDCTN_BEGN_D8
L2000DTP03Education End (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_EDCTN_END_D8
L2000DTP03Eligibility Begin (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_ELIG_BEGN_D8
L2000DTP03Eligibility End (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_ELIG_END_D8
L2000DTP03Adjusted Hire (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_ADJSTD_HIR_D8
L2000DTP03Plan Participation Suspension (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_PLAN_PARTCPTN_SUSPNSN_D8
L2000DTP03Rehire (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_REHR_D8
L2000DTP03Medicaid Begin (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_MEDCD_BEGN_D8
L2000DTP03Medicaid End (D8)L2000_S06_DTP03_STATS_NFO_EFF_DT_OVL_MEDCD_END_D8

2100A - MEMBER NAME

LoopSegmentSegment NameChiapas Gate Mapping
2100AQualified Loop
L2100ACorrected InsuredL2100A_74
L2100AInsured or SubscriberL2100A_IL
L2100ANM1Member Name
L2100ANM103PersonL2100A_XX_S01_NM103_SUB_LNAME_OVL_PERSN
L2100ANM104Subscriber First NameL2100A_XX_S01_NM104_SUB_FNAME
L2100ANM105Subscriber Middle NameL2100A_XX_S01_NM105_SUB_MNAME
L2100ANM106Subscriber Name PrefixL2100A_XX_S01_NM106_SUB_NM_PREFX
L2100ANM107Subscriber Name SuffixL2100A_XX_S01_NM107_SUB_NM_SUFX
L2100ANM109Social Security NumberL2100A_XX_S01_NM109_SUB_ID_OVL_SSN
L2100ANM109Mutually DefinedL2100A_XX_S01_NM109_SUB_ID_OVL_MUTLY_DEFND
L2100APERMember Communications Numbers
L2100APER01Contact Function CodeL2100A_XX_S02_PER01_CONTCT_FUNCTN_CD
L2100APER04Electronic MailL2100A_XX_S02_PER04_COMM_NR_OVL_EMAIL
L2100APER04Telephone ExtensionL2100A_XX_S02_PER04_COMM_NR_OVL_PHN_EXTNS
L2100APER04FacsimileL2100A_XX_S02_PER04_COMM_NR_OVL_FACSML
L2100APER04Home Phone NumberL2100A_XX_S02_PER04_COMM_NR_OVL_HOM_PHON_NR
L2100APER04TelephoneL2100A_XX_S02_PER04_COMM_NR_OVL_TELPHN
L2100APER04Work Phone NumberL2100A_XX_S02_PER04_COMM_NR_OVL_WORK_PHON_NR
L2100APER06TelephoneL2100A_XX_S02_PER06_COMM_NR_OVL_TELPHN
L2100APER06Work Phone NumberL2100A_XX_S02_PER06_COMM_NR_OVL_WORK_PHON_NR
L2100APER08Electronic MailL2100A_XX_S02_PER08_COMM_NR_OVL_EMAIL
L2100APER08Telephone ExtensionL2100A_XX_S02_PER08_COMM_NR_OVL_PHN_EXTNS
L2100APER08FacsimileL2100A_XX_S02_PER08_COMM_NR_OVL_FACSML
L2100APER08Home Phone NumberL2100A_XX_S02_PER08_COMM_NR_OVL_HOM_PHON_NR
L2100APER08TelephoneL2100A_XX_S02_PER08_COMM_NR_OVL_TELPHN
L2100APER08Work Phone NumberL2100A_XX_S02_PER08_COMM_NR_OVL_WORK_PHON_NR
L2100AN3Member Residence Street Address
L2100AN301Subscriber Address LineL2100A_XX_S03_N301_SUB_ADRS_LIN
L2100AN302Subscriber Address LineL2100A_XX_S03_N302_SUB_ADRS_LIN
L2100AN4Member Residence City, State, ZIP Code
L2100AN401Subscriber City NameL2100A_XX_S04_N401_SUB_CITY_NM
L2100AN402Subscriber State CodeL2100A_XX_S04_N402_SUB_STAT_CD
L2100AN403Subscriber Postal Zone or ZIP CodeL2100A_XX_S04_N403_SUB_POSTL_ZON_ZIP_CD
L2100AN404Country CodeL2100A_XX_S04_N404_CNTRY_CD
L2100AN406AreaL2100A_XX_S04_N406_LOC_ID_CD_OVL_AR
L2100AN406County/ParishL2100A_XX_S04_N406_LOC_ID_CD_OVL_COUNTY_PRSH
L2100ADMGMember Demographics
L2100ADMG02Date Expressed in Format CCYYMMDDL2100A_XX_S05_DMG02_BIRTH_DT_OVL_DT_CCYYMMDD
L2100ADMG03Gender CodeL2100A_XX_S05_DMG03_GENDR_CD
L2100ADMG04Marital Status CodeL2100A_XX_S05_DMG04_MARTL_STATS_CD
L2100ADMG05Race or Ethnicity CodeL2100A_XX_S05_DMG05_RAC_ETHNCTY_CD
L2100ADMG06Citizenship Status CodeL2100A_XX_S05_DMG06_CITZNSHP_STATS_CD
L2100AICMMember Income
L2100AICM02WeeklyL2100A_XX_S06_ICM02_WAG_AMT_OVL_WEKLY
L2100AICM02BiweeklyL2100A_XX_S06_ICM02_WAG_AMT_OVL_BIWKLY
L2100AICM02SemimonthlyL2100A_XX_S06_ICM02_WAG_AMT_OVL_SEMNTHLY
L2100AICM02MonthlyL2100A_XX_S06_ICM02_WAG_AMT_OVL_MONTHLY
L2100AICM02DailyL2100A_XX_S06_ICM02_WAG_AMT_OVL_DAILY
L2100AICM02AnnualL2100A_XX_S06_ICM02_WAG_AMT_OVL_ANL
L2100AICM02Two Calendar MonthsL2100A_XX_S06_ICM02_WAG_AMT_OVL_TWO_CALNDR_MONTHS
L2100AICM02Lump-Sum Separation AllowanceL2100A_XX_S06_ICM02_WAG_AMT_OVL_LUMPSM_SEPRTN_ALWNC
L2100AICM02Year-to-DateL2100A_XX_S06_ICM02_WAG_AMT_OVL_YEARTDT
L2100AICM02SingleL2100A_XX_S06_ICM02_WAG_AMT_OVL_SINGL
L2100AICM02HourlyL2100A_XX_S06_ICM02_WAG_AMT_OVL_HOURLY
L2100AICM02QuarterlyL2100A_XX_S06_ICM02_WAG_AMT_OVL_QUARTRLY
L2100AICM02SemiannualL2100A_XX_S06_ICM02_WAG_AMT_OVL_SEMNL
L2100AICM02UnknownL2100A_XX_S06_ICM02_WAG_AMT_OVL_UNKNWN
L2100AICM03Work Hours CountL2100A_XX_S06_ICM03_WORK_HOURS_CT
L2100AICM04Location Identification CodeL2100A_XX_S06_ICM04_LOC_ID_CD
L2100AICM05Salary Grade CodeL2100A_XX_S06_ICM05_SALRY_GRAD_CD
L2100AAMTMember Policy Amounts
L2100AAMT02Co-insurance - ActualL2100A_XX_S07_AMT02_CONTRCT_AMT_OVL_CONSRNC_ACTL
L2100AAMT02Co-Payment AmountL2100A_XX_S07_AMT02_CONTRCT_AMT_OVL_COPYMNT_AMT
L2100AAMT02Deductible AmountL2100A_XX_S07_AMT02_CONTRCT_AMT_OVL_DEDCTBL_AMT
L2100AAMT02Premium AmountL2100A_XX_S07_AMT02_CONTRCT_AMT_OVL_PREM_AMT
L2100AHLHMember Health Information
L2100AHLH01Health Related CodeL2100A_XX_S08_HLH01_RELTD_CD
L2100AHLH02Member HeightL2100A_XX_S08_HLH02_MEM_HEIGHT
L2100AHLH03Member WeightL2100A_XX_S08_HLH03_MEM_WEIGHT
L2100ALUIMember Language
L2100ALUI02NISO Z39.53 Language CodesL2100A_XX_S09_LUI02_LANG_CD_OVL_NIS_Z3953_LANG_CD
L2100ALUI02ISO 639 Language CodesL2100A_XX_S09_LUI02_LANG_CD_OVL_IS_639_LANG_CD
L2100ALUI03Language DescriptionL2100A_XX_S09_LUI03_LANG_DESCRPTN
L2100ALUI04Language Use IndicatorL2100A_XX_S09_LUI04_LANG_US_IND

2100B - INCORRECT MEMBER NAME

LoopSegmentSegment NameChiapas Gate Mapping
L2100BNM1Incorrect Member Name
L2100BNM103PersonL2100B_S01_NM103_PRI_INCRCT_INSRD_LNAME_OVL_PERSN
L2100BNM104Prior Incorrect Insured First NameL2100B_S01_NM104_PRI_INCRCT_INSRD_FNAME
L2100BNM105Prior Incorrect Insured Middle NameL2100B_S01_NM105_PRI_INCRCT_INSRD_MNAME
L2100BNM106Prior Incorrect Insured Name PrefixL2100B_S01_NM106_PRI_INCRCT_INSRD_NM_PREFX
L2100BNM107Prior Incorrect Insured Name SuffixL2100B_S01_NM107_PRI_INCRCT_INSRD_NM_SUFX
L2100BNM109Social Security NumberL2100B_S01_NM109_PRI_INCRCT_INSRD_ID_OVL_SSN
L2100BNM109Mutually DefinedL2100B_S01_NM109_PRI_INCRCT_INSRD_ID_OVL_MUTLY_DEFND
L2100BDMGIncorrect Member Demographics
L2100BDMG02Date Expressed in Format CCYYMMDDL2100B_S02_DMG02_PRI_INCRCT_INSRD_BIRTH_DT_OVL_DT_CCYYMMDD
L2100BDMG03Prior Incorrect Insured Gender CodeL2100B_S02_DMG03_PRI_INCRCT_INSRD_GENDR_CD

2100C - MEMBER MAILING ADDRESS

LoopSegmentSegment NameChiapas Gate Mapping
L2100CNM1Member Mailing Address
L2100CNM102Entity Type QualifierL2100C_S01_NM102_ENTY_TYPE_QUAL
L2100CN3Member Mail Street Address
L2100CN301Subscriber Address LineL2100C_S02_N301_SUB_ADRS_LIN
L2100CN302Subscriber Address LineL2100C_S02_N302_SUB_ADRS_LIN
L2100CN4Member Mail City, State, Zip
L2100CN401Subscriber City NameL2100C_S03_N401_SUB_CITY_NM
L2100CN402Subscriber State CodeL2100C_S03_N402_SUB_STAT_CD
L2100CN403Subscriber Postal Zone or ZIP CodeL2100C_S03_N403_SUB_POSTL_ZON_ZIP_CD
L2100CN404Country CodeL2100C_S03_N404_CNTRY_CD

2100D - MEMBER EMPLOYER

LoopSegmentSegment NameChiapas Gate Mapping
L2100DNM1Member Employer
L2100DNM102Entity Type QualifierL2100D_S01_NM102_ENTY_TYPE_QUAL
L2100DNM103Insured Employer NameL2100D_S01_NM103_INSRD_EMPLYR_NM
L2100DNM104Insured Employer First NameL2100D_S01_NM104_INSRD_EMPLYR_FNAME
L2100DNM105Insured Employer Middle NameL2100D_S01_NM105_INSRD_EMPLYR_MNAME
L2100DNM107Insured Employer Name SuffixL2100D_S01_NM107_INSRD_EMPLYR_NM_SUFX
L2100DNM109Mutually DefinedL2100D_S01_NM109_INSRD_EMPLYR_ID_OVL_MUTLY_DEFND
L2100DPERMember Employer Communications Numbers
L2100DPER01Contact Function CodeL2100D_S02_PER01_CONTCT_FUNCTN_CD
L2100DPER04Electronic MailL2100D_S02_PER04_COMM_NR_OVL_EMAIL
L2100DPER04Telephone ExtensionL2100D_S02_PER04_COMM_NR_OVL_PHN_EXTNS
L2100DPER04FacsimileL2100D_S02_PER04_COMM_NR_OVL_FACSML
L2100DPER04TelephoneL2100D_S02_PER04_COMM_NR_OVL_TELPHN
L2100DPER05Communication Number QualifierL2100D_S02_PER05_COMM_NR_QUAL
L2100DPER06Communication NumberL2100D_S02_PER06_COMM_NR
L2100DPER08Electronic MailL2100D_S02_PER08_COMM_NR_OVL_EMAIL
L2100DPER08Telephone ExtensionL2100D_S02_PER08_COMM_NR_OVL_PHN_EXTNS
L2100DPER08FacsimileL2100D_S02_PER08_COMM_NR_OVL_FACSML
L2100DPER08TelephoneL2100D_S02_PER08_COMM_NR_OVL_TELPHN
L2100DN3Member Employer Street Address
L2100DN301Insured Employer Address LineL2100D_S03_N301_INSRD_EMPLYR_ADRS_LIN
L2100DN302Insured Employer Address LineL2100D_S03_N302_INSRD_EMPLYR_ADRS_LIN
L2100DN4Member Employer City, State, Zip
L2100DN401Insured Employer City NameL2100D_S04_N401_INSRD_EMPLYR_CITY_NM
L2100DN402Insured Employer State CodeL2100D_S04_N402_INSRD_EMPLYR_STAT_CD
L2100DN403Insured Employer Postal Zone or ZIP CodeL2100D_S04_N403_INSRD_EMPLYR_POSTL_ZON_ZIP_CD
L2100DN404Country CodeL2100D_S04_N404_CNTRY_CD

2100E - MEMBER SCHOOL

LoopSegmentSegment NameChiapas Gate Mapping
L2100ENM1Member School
L2100ENM103Non-Person EntityL2100E_S01_NM103_SCHOL_NM_OVL_NONPRSN_ENTY
L2100EPERMember School Commmunications Numbers
L2100EPER01Contact Function CodeL2100E_S02_PER01_CONTCT_FUNCTN_CD
L2100EPER04Electronic MailL2100E_S02_PER04_COMM_NR_OVL_EMAIL
L2100EPER04Telephone ExtensionL2100E_S02_PER04_COMM_NR_OVL_PHN_EXTNS
L2100EPER04FacsimileL2100E_S02_PER04_COMM_NR_OVL_FACSML
L2100EPER04TelephoneL2100E_S02_PER04_COMM_NR_OVL_TELPHN
L2100EPER05Communication Number QualifierL2100E_S02_PER05_COMM_NR_QUAL
L2100EPER06Communication NumberL2100E_S02_PER06_COMM_NR
L2100EPER08Electronic MailL2100E_S02_PER08_COMM_NR_OVL_EMAIL
L2100EPER08Telephone ExtensionL2100E_S02_PER08_COMM_NR_OVL_PHN_EXTNS
L2100EPER08FacsimileL2100E_S02_PER08_COMM_NR_OVL_FACSML
L2100EPER08TelephoneL2100E_S02_PER08_COMM_NR_OVL_TELPHN
L2100EN3Member School Street Address
L2100EN301School Address LineL2100E_S03_N301_ADRS_LIN
L2100EN302School Address LineL2100E_S03_N302_ADRS_LIN
L2100EN4Member School City, State, Zip
L2100EN401School City NameL2100E_S04_N401_CITY_NM
L2100EN402School State CodeL2100E_S04_N402_STAT_CD
L2100EN403School Postal Zone or ZIP CodeL2100E_S04_N403_SCHOL_POSTL_ZON_ZIP_CD
L2100EN404Country CodeL2100E_S04_N404_CNTRY_CD

2100F - CUSTODIAL PARENT

LoopSegmentSegment NameChiapas Gate Mapping
L2100FNM1Custodial Parent
L2100FNM103PersonL2100F_S01_NM103_PARNT_LNAME_OVL_PERSN
L2100FNM104Custodial Parent First NameL2100F_S01_NM104_PARNT_FNAME
L2100FNM105Custodial Parent Middle NameL2100F_S01_NM105_PARNT_MNAME
L2100FNM106Custodial Parent Name PrefixL2100F_S01_NM106_CUSTDL_PARNT_NM_PREFX
L2100FNM107Custodial Parent Name SuffixL2100F_S01_NM107_CUSTDL_PARNT_NM_SUFX
L2100FNM109Social Security NumberL2100F_S01_NM109_PARNT_ID_OVL_SSN
L2100FNM109Mutually DefinedL2100F_S01_NM109_PARNT_ID_OVL_MUTLY_DEFND
L2100FPERCustodial Parent Communications Numbers
L2100FPER01Contact Function CodeL2100F_S02_PER01_CONTCT_FUNCTN_CD
L2100FPER04Electronic MailL2100F_S02_PER04_COMM_NR_OVL_EMAIL
L2100FPER04Telephone ExtensionL2100F_S02_PER04_COMM_NR_OVL_PHN_EXTNS
L2100FPER04FacsimileL2100F_S02_PER04_COMM_NR_OVL_FACSML
L2100FPER04Home Phone NumberL2100F_S02_PER04_COMM_NR_OVL_HOM_PHON_NR
L2100FPER04TelephoneL2100F_S02_PER04_COMM_NR_OVL_TELPHN
L2100FPER04Work Phone NumberL2100F_S02_PER04_COMM_NR_OVL_WORK_PHON_NR
L2100FPER06TelephoneL2100F_S02_PER06_COMM_NR_OVL_TELPHN
L2100FPER06Work Phone NumberL2100F_S02_PER06_COMM_NR_OVL_WORK_PHON_NR
L2100FPER08Electronic MailL2100F_S02_PER08_COMM_NR_OVL_EMAIL
L2100FPER08Telephone ExtensionL2100F_S02_PER08_COMM_NR_OVL_PHN_EXTNS
L2100FPER08Home Phone NumberL2100F_S02_PER08_COMM_NR_OVL_HOM_PHON_NR
L2100FPER08TelephoneL2100F_S02_PER08_COMM_NR_OVL_TELPHN
L2100FPER08Work Phone NumberL2100F_S02_PER08_COMM_NR_OVL_WORK_PHON_NR
L2100FN3Custodial Parent Street Address
L2100FN301Custodial Parent Address LineL2100F_S03_N301_CUSTDL_PARNT_ADRS_LIN
L2100FN302Custodial Parent Address LineL2100F_S03_N302_CUSTDL_PARNT_ADRS_LIN
L2100FN4Custodial Parent City, State, Zip
L2100FN401Custodial Parent City NameL2100F_S04_N401_CUSTDL_PARNT_CITY_NM
L2100FN402Custodial Parent State CodeL2100F_S04_N402_CUSTDL_PARNT_STAT_CD
L2100FN403Custodial Parent Postal Zone or ZIP CodeL2100F_S04_N403_POSTL_ZON_ZIP_CD
L2100FN404Country CodeL2100F_S04_N404_CNTRY_CD

2100G - RESPONSIBLE PERSON

LoopSegmentSegment NameChiapas Gate Mapping
2100GQualified Loop
L2100GExecutor of EstateL2100G_EI
L2100GEx-spouseL2100G_EXS
L2100GGuardianL2100G_GD
L2100GPower of AttorneyL2100G_J6
L2100GResponsible PartyL2100G_QD
L2100GNM1Responsible Person
L2100GNM103PersonL2100G_XX_S01_NM103_RESPNSBL_PARTY_LAST_ORG_NM_OVL_PERSN
L2100GNM104Responsible Party First NameL2100G_XX_S01_NM104_PARTY_FNAME
L2100GNM105Responsible Party Middle NameL2100G_XX_S01_NM105_PARTY_MNAME
L2100GNM106Responsible Party Name PrefixL2100G_XX_S01_NM106_RESPNSBL_PARTY_NM_PREFX
L2100GNM107Responsible Party Suffix NameL2100G_XX_S01_NM107_RESPNSBL_PARTY_SUFX_NM
L2100GNM109Social Security NumberL2100G_XX_S01_NM109_PARTY_ID_OVL_SSN
L2100GNM109Mutually DefinedL2100G_XX_S01_NM109_PARTY_ID_OVL_MUTLY_DEFND
L2100GPERResponsible Person Communications Numbers
L2100GPER01Contact Function CodeL2100G_XX_S02_PER01_CONTCT_FUNCTN_CD
L2100GPER04Electronic MailL2100G_XX_S02_PER04_COMM_NR_OVL_EMAIL
L2100GPER04Telephone ExtensionL2100G_XX_S02_PER04_COMM_NR_OVL_PHN_EXTNS
L2100GPER04FacsimileL2100G_XX_S02_PER04_COMM_NR_OVL_FACSML
L2100GPER04Home Phone NumberL2100G_XX_S02_PER04_COMM_NR_OVL_HOM_PHON_NR
L2100GPER04TelephoneL2100G_XX_S02_PER04_COMM_NR_OVL_TELPHN
L2100GPER04Work Phone NumberL2100G_XX_S02_PER04_COMM_NR_OVL_WORK_PHON_NR
L2100GPER06TelephoneL2100G_XX_S02_PER06_COMM_NR_OVL_TELPHN
L2100GPER06Work Phone NumberL2100G_XX_S02_PER06_COMM_NR_OVL_WORK_PHON_NR
L2100GPER08Electronic MailL2100G_XX_S02_PER08_COMM_NR_OVL_EMAIL
L2100GPER08Telephone ExtensionL2100G_XX_S02_PER08_COMM_NR_OVL_PHN_EXTNS
L2100GPER08FacsimileL2100G_XX_S02_PER08_COMM_NR_OVL_FACSML
L2100GPER08Home Phone NumberL2100G_XX_S02_PER08_COMM_NR_OVL_HOM_PHON_NR
L2100GPER08TelephoneL2100G_XX_S02_PER08_COMM_NR_OVL_TELPHN
L2100GPER08Work Phone NumberL2100G_XX_S02_PER08_COMM_NR_OVL_WORK_PHON_NR
L2100GN3Responsible Person Street Address
L2100GN301Responsible Party Address LineL2100G_XX_S03_N301_RESPNSBL_PARTY_ADRS_LIN
L2100GN302Responsible Party Address LineL2100G_XX_S03_N302_RESPNSBL_PARTY_ADRS_LIN
L2100GN4Responsible Person City, State, Zip
L2100GN401Responsible Party City NameL2100G_XX_S04_N401_RESPNSBL_PARTY_CITY_NM
L2100GN402Responsible Party State CodeL2100G_XX_S04_N402_RESPNSBL_PARTY_STAT_CD
L2100GN403Responsible Party Postal Zone or ZIP CodeL2100G_XX_S04_N403_RESPNSBL_PARTY_POSTL_ZON_ZIP_CD
L2100GN404Country CodeL2100G_XX_S04_N404_CNTRY_CD

2200 - DISABILITY INFORMATION

LoopSegmentSegment NameChiapas Gate Mapping
L2200DSBDisability Information
L2200DSB01Disability Type CodeL2200_S01_DSB01_TYPE_CD
L2200DSB08International Classification of Diseases Clinical Modification (ICD-9-CM) - DiagnosisL2200_S01_DSB08_DIAG_CD_OVL_ICD9CM_DIAG
L2200DTPDisability Eligibility Dates
L2200DTP03Disability Begin (D8)L2200_S02_DTP03_ELIG_DT_OVL_DISBLTY_BEGN_D8
L2200DTP03Disability End (D8)L2200_S02_DTP03_ELIG_DT_OVL_DISBLTY_END_D8

2300 - HEALTH COVERAGE

LoopSegmentSegment NameChiapas Gate Mapping
L2300HDHealth Coverage
L2300HD01Maintenance Type CodeL2300_S01_HD01_MAINTNC_TYPE_CD
L2300HD03Insurance Line CodeL2300_S01_HD03_INS_LIN_CD
L2300HD04Plan Coverage DescriptionL2300_S01_HD04_PLAN_COVG_DESCRPTN
L2300HD05Coverage Level CodeL2300_S01_HD05_COVG_LEVL_CD
L2300DTPHealth Coverage Dates
L2300DTP03Maintenance Effective (D8)L2300_S02_DTP03_COVG_PERD_OVL_MAINTNC_EFF_D8
L2300DTP03Benefit Begin (D8)L2300_S02_DTP03_COVG_PERD_OVL_BENFT_BEGN_D8
L2300DTP03Benefit End (D8)L2300_S02_DTP03_COVG_PERD_OVL_BENFT_END_D8
L2300DTP03Last Premium Paid Date (D8)L2300_S02_DTP03_COVG_PERD_OVL_LAST_PREM_PD_DT_D8
L2300AMTHealth Coverage Policy
L2300AMT02Co-insurance - ActualL2300_S03_AMT02_CONTRCT_AMT_OVL_CONSRNC_ACTL
L2300AMT02Co-Payment AmountL2300_S03_AMT02_CONTRCT_AMT_OVL_COPYMNT_AMT
L2300AMT02Deductible AmountL2300_S03_AMT02_CONTRCT_AMT_OVL_DEDCTBL_AMT
L2300AMT02Premium AmountL2300_S03_AMT02_CONTRCT_AMT_OVL_PREM_AMT
L2300REFHealth Coverage Policy Number
L2300REF02Client Reporting CategoryL2300_S04_REF02_INSRD_GRP_POLCY_NR_OVL_CLIENT_REPRTNG_CATGRY
L2300REF02Group or Policy NumberL2300_S04_REF02_INSRD_GRP_POLCY_NR_OVL_GRP_POLCY_NR
L2300REF02Mutually DefinedL2300_S04_REF02_INSRD_GRP_POLCY_NR_OVL_MUTLY_DEFND
L2300IDCIdentification Card
L2300IDC01Plan Coverage DescriptionL2300_S05_IDC01_PLAN_COVG_DESCRPTN
L2300IDC02Identification Card Type CodeL2300_S05_IDC02_ID_CARD_TYPE_CD
L2300IDC03Identification Card CountL2300_S05_IDC03_CARD_CT
L2300IDC04Action CodeL2300_S05_IDC04_ACTN_CD

2310 - PROVIDER INFORMATION

LoopSegmentSegment NameChiapas Gate Mapping
L2310LXProvider Information
L2310LX01Assigned NumberL2310_S01_LX01_ASGND_NR
L2310NM1Provider Name
L2310NM101Entity Identifier CodeL2310_S02_NM101_ENTY_ID_CD
L2310NM102Entity Type QualifierL2310_S02_NM102_ENTY_TYPE_QUAL
L2310NM103Provider Last or Organization NameL2310_S02_NM103_PROV_LAST_ORG_NM
L2310NM104Provider First NameL2310_S02_NM104_PROV_FNAME
L2310NM105Provider Middle NameL2310_S02_NM105_PROV_MNAME
L2310NM106Provider Name PrefixL2310_S02_NM106_NM_PREFX
L2310NM107Provider Name SuffixL2310_S02_NM107_NM_SUFX
L2310NM109Social Security NumberL2310_S02_NM109_PROV_ID_OVL_SSN
L2310NM109Federal Taxpayer’s Identification NumberL2310_S02_NM109_PROV_ID_OVL_FED_TAX_ID_NR
L2310NM109Health Care Financing Administration NationalL2310_S02_NM109_PROV_ID_OVL_HCFA_NATNL
L2310NM110Entity Relationship CodeL2310_S02_NM110_ENTY_REL_CD
L2310N4Provider City, State, ZIP Code
L2310N401Member City NameL2310_S03_N401_MEM_CITY_NM
L2310N402Member State CodeL2310_S03_N402_MEM_STAT_CD
L2310N403Member Postal Zone or Zip CodeL2310_S03_N403_MEM_POSTL_ZON_ZIP_CD
L2310N404Country CodeL2310_S03_N404_CNTRY_CD
L2310N406AreaL2310_S03_N406_LOC_ID_CD_OVL_AR
L2310N406County/ParishL2310_S03_N406_LOC_ID_CD_OVL_COUNTY_PRSH
L2310N406RegionL2310_S03_N406_LOC_ID_CD_OVL_REGN
L2310PERProvider Communications Numbers
L2310PER01Contact Function CodeL2310_S04_PER01_CONTCT_FUNCTN_CD
L2310PER04Electronic MailL2310_S04_PER04_COMM_NR_OVL_EMAIL
L2310PER04Telephone ExtensionL2310_S04_PER04_COMM_NR_OVL_PHN_EXTNS
L2310PER04FacsimileL2310_S04_PER04_COMM_NR_OVL_FACSML
L2310PER04Home Phone NumberL2310_S04_PER04_COMM_NR_OVL_HOM_PHON_NR
L2310PER04TelephoneL2310_S04_PER04_COMM_NR_OVL_TELPHN
L2310PER04Work Phone NumberL2310_S04_PER04_COMM_NR_OVL_WORK_PHON_NR
L2310PER06Electronic MailL2310_S04_PER06_COMM_NR_OVL_EMAIL
L2310PER06Telephone ExtensionL2310_S04_PER06_COMM_NR_OVL_PHN_EXTNS
L2310PER06FacsimileL2310_S04_PER06_COMM_NR_OVL_FACSML
L2310PER06Home Phone NumberL2310_S04_PER06_COMM_NR_OVL_HOM_PHON_NR
L2310PER06TelephoneL2310_S04_PER06_COMM_NR_OVL_TELPHN
L2310PER06Work Phone NumberL2310_S04_PER06_COMM_NR_OVL_WORK_PHON_NR
L2310PER08Electronic MailL2310_S04_PER08_COMM_NR_OVL_EMAIL
L2310PER08Telephone ExtensionL2310_S04_PER08_COMM_NR_OVL_PHN_EXTNS
L2310PER08FacsimileL2310_S04_PER08_COMM_NR_OVL_FACSML
L2310PER08Home Phone NumberL2310_S04_PER08_COMM_NR_OVL_HOM_PHON_NR
L2310PER08TelephoneL2310_S04_PER08_COMM_NR_OVL_TELPHN
L2310PER08Work Phone NumberL2310_S04_PER08_COMM_NR_OVL_WORK_PHON_NR
L2310PLAPCP Change Reason
L2310PLA01Action CodeL2310_S05_PLA01_ACTN_CD
L2310PLA02Entity Identifier CodeL2310_S05_PLA02_ENTY_ID_CD
L2310PLA03Provider Effective DateL2310_S05_PLA03_PROV_EFF_DT
L2310PLA05Maintenance Reason CodeL2310_S05_PLA05_MAINTNC_RSN_CD

2320 - COORDINATION OF BENEFITS

LoopSegmentSegment NameChiapas Gate Mapping
L2320COBCoordination of Benefits
L2320COB01Payer Responsibility Sequence Number CodeL2320_S01_COB01_PAYR_RESP_SEQNC_NR_CD
L2320COB02Insured Group or Policy NumberL2320_S01_COB02_INSRD_GRP_POLCY_NR
L2320COB03Coordination of Benefits CodeL2320_S01_COB03_COB_CD
L2320REFAdditional Coordination of Benefits Identifiers
L2320REF02Account Suffix CodeL2320_S02_REF02_INSRD_GRP_POLCY_NR_OVL_ACNT_SUFX_CD
L2320REF02Group NumberL2320_S02_REF02_INSRD_GRP_POLCY_NR_OVL_GRP_NR
L2320REF02Employee Identification NumberL2320_S02_REF02_INSRD_GRP_POLCY_NR_OVL_EMPLY_ID_NR
L2320REF02Social Security NumberL2320_S02_REF02_INSRD_GRP_POLCY_NR_OVL_SSN
L2320REF02Mutually DefinedL2320_S02_REF02_INSRD_GRP_POLCY_NR_OVL_MUTLY_DEFND
L2320N1Other Insurance Company Name
L2320N101Entity Identifier CodeL2320_S03_N101_ENTY_ID_CD
L2320N102Insurer NameL2320_S03_N102_INSR_NM
L2320N104Federal Taxpayer’s Identification NumberL2320_S03_N104_INSRD_GRP_POLCY_NR_OVL_FED_TAX_ID_NR
L2320N104National Association of Insurance CommissionersL2320_S03_N104_INSRD_GRP_POLCY_NR_OVL_NAIC
L2320N104Health Care Financing Administration National PlanIDL2320_S03_N104_INSRD_GRP_POLCY_NR_OVL_HCFA_NATNL_PLAND
L2320DTPCoordination of Benefits Eligibility Dates
L2320DTP03Coordination of Benefits Begin (D8)L2320_S04_DTP03_COB_DT_OVL_COB_BEGN_D8
L2320DTP03Coordination of Benefits End (D8)L2320_S04_DTP03_COB_DT_OVL_COB_END_D8