Chiapas EDI 2012 Mapping Guide

(C) Copyright 2012 Chiapas EDI Technologies, Inc.

5010_820X 5010 820X Health Insurance Exchange Related Payments - Code:S5

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
STHDRST03Implementation Guide Version NameSTHDR_S01_ST03_IMPLMNTN_GUID_VERSN_NM
STHDRBPRFinancial Information
STHDRBPR01Transaction Handling CodeSTHDR_S02_BPR01_TRANSCTN_HANDLNG_CD
STHDRBPR02Total Payment AmountSTHDR_S02_BPR02_TOTL_PMT_AMT
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
STHDRBPR11Originating Company Supplemental CodeSTHDR_S02_BPR11_ORGNTNG_CO_SUPP_CD
STHDRBPR13ABA Transit Routing Number Including Check Digits (9 digits)STHDR_S02_BPR13_DFI_ID_NR_OVL_ABA_RTNG_NR
STHDRBPR13Swift Identification (8 or 11 characters)STHDR_S02_BPR13_DFI_ID_NR_OVL_SWIFT_ID
STHDRBPR13Canadian Bank Branch and Institution NumberSTHDR_S02_BPR13_DFI_ID_NR_OVL_CANDN_BANK_NR
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 Trace Number
STHDRTRN01Trace Type CodeSTHDR_S03_TRN01_TYPE_CD
STHDRTRN02Check or EFT Trace NumberSTHDR_S03_TRN02_CHK_EFT_TRAC_NR
STHDRREFExchange Assigned Qualified Health Plan Identifier
STHDRREF02Master Policy NumberSTHDR_S04_REF02_EXCHG_HLTH_PLAN_ID_OVL_MASTR_POLCY_NR
STHDRREFIssuer Assigned Qualified Health Plan Identifier
STHDRREF02Line of BusinessSTHDR_S05_REF02_EXCHG_HLTH_PLAN_ID_OVL_LIN_OF_BUSNS
STHDRREFExchange Assigned Employer Group Identifier
STHDRREF02Plan NumberSTHDR_S06_REF02_EXCHG_ASSGN_EMP_GRP_ID_OVL_PLAN_NR
STHDRREFIssuer Assigned Employer Group Identifier
STHDRREF02Group or Policy NumberSTHDR_S07_REF02_ISSR_ASSGN_EMP_GRP_ID_OVL_GRP_POLCY_NR
STHDRSETransaction Set Trailer
STHDRSE01Transaction Segment CountSTHDR_S11_SE01_SEG_CT
STHDRSE02Transaction Set Control NumberSTHDR_S11_SE02_TCN

1000A - Payee Name

LoopSegmentSegment NameChiapas Gate Mapping
L1000AN1Payee Name
L1000AN102Payee Organization NameL1000A_S01_N102_PAYEE_ORG_NM
L1000AN104Federal Taxpayers Identification NumberL1000A_S01_N104_PAYEE_TAX_ID_NR_OVL_FED_TAX_ID_NR
L1000AREFUnique Health Plan Identifier
L1000AREF02Centers for Medicare and Medicaid Services Plan IDL1000A_S02_REF02_UNQ_HLTH_PLAN_ID_OVL_MDCR_MDCD_PLAN_ID

1000B - Payers Name

LoopSegmentSegment NameChiapas Gate Mapping
L1000BN1Payers Name
L1000BN102Payer NameL1000B_S01_N102_PAYER_NM
L1000BN104Originating Company NumberL1000B_S01_N104_PAYER_ID_OVL_ORGN_CO_NR
L1000BPERPayers Administrative Contact Information
L1000BPER01Contact Function CodeL1000B_S02_PER01_FUNCTN_CD
L1000BPER02Premium Payer Contact NameL1000B_S02_PER02_PREM_PYR_CONTCT_NM
L1000BPER04Electronic MailL1000B_S02_PER04_COMNCTN_NR_OVL_EMAIL
L1000BPER04FacsimileL1000B_S02_PER04_COMNCTN_NR_OVL_FACSML
L1000BPER04TelephoneL1000B_S02_PER04_COMNCTN_NR_OVL_TELPHN
L1000BPER06Electronic MailL1000B_S02_PER06_NFO_RECVR_COMNCTN_NR_OVL_EMAIL
L1000BPER06Telephone ExtensionL1000B_S02_PER06_NFO_RECVR_COMNCTN_NR_OVL_PHN_EXTNS
L1000BPER06FacsimileL1000B_S02_PER06_NFO_RECVR_COMNCTN_NR_OVL_FACSML
L1000BPER06TelephoneL1000B_S02_PER06_NFO_RECVR_COMNCTN_NR_OVL_TELPHN
L1000BPER08Electronic MailL1000B_S02_PER08_NFO_RECVR_COMNCTN_NR_OVL_EMAIL
L1000BPER08Telephone ExtensionL1000B_S02_PER08_NFO_RECVR_COMNCTN_NR_OVL_PHN_EXTNS
L1000BPER08FacsimileL1000B_S02_PER08_NFO_RECVR_COMNCTN_NR_OVL_FACSML
L1000BPER08TelephoneL1000B_S02_PER08_NFO_RECVR_COMNCTN_NR_OVL_TELPHN

2000 - Remittance Information

LoopSegmentSegment NameChiapas Gate Mapping
L2000ENTRemittance Information
L2000ENT01Assigned NumberL2000_S01_ENT01_ASGND_NR

2100 - Individual Name

LoopSegmentSegment NameChiapas Gate Mapping
L2100NM1Individual Name
L2100NM102Entity Type QualifierL2100_S01_NM102_ENTY_TYPE_QUAL
L2100NM103Indvidual Last NameL2100_S01_NM103_INDVDL_LAST_NM
L2100NM104Individual First NameL2100_S01_NM104_INDVDL_FRST_NM
L2100NM105Individual Middle NameL2100_S01_NM105_INDVDL_MDDL_NM
L2100NM106Individual Name PrefixL2100_S01_NM106_INDVDL_NM_PREFX
L2100NM107Individual Name SuffixL2100_S01_NM107_NFO_SOURC_NM_SUFX
L2100NM109Insured or SubscriberL2100_S01_NM109_EXCHNG_ASSGND_SUB_ID_OVL_INSRD_SUBSCRBR
L2100REFExchange Assigned Qualified Health Plan Identifier
L2100REF02Master Policy NumberL2100_S02_REF02_EXCHG_ASSGND_QUAL_HLTH_PLAN_ID_OVL_MASTR_POLCY_NR
L2100REFIssuer Assigned Qualified Health Plan Identifier
L2100REF02Line of BusinessL2100_S03_REF02_ISSR_ASSGND_QUAL_HLTH_PLAN_ID_OVL_LOB
L2100REFExchange Assigned Employer Group Identifier
L2100REF02Plan NumberL2100_S04_REF02_EXCHG_ASSGND_EMP_GRP_ID_OVL_PLAN_NR
L2100REFIssuer Assigned Employer Group Identifier
L2100REF02Group or Policy NumberL2100_S05_REF02_ISSR_ASSGND_EMP_GRP_ID_OVL_GRP_POLCY_NR
L2100REFExchange Assigned Policy Identifier
L2100REF02Policy NumberL2100_S06_REF02_EXCHG_ASSGND_POLCY_ID_OVL_POLCY_NR
L2100REFIssuer Assigned Policy Identifier
L2100REF02Health Insurance Policy NumberL2100_S07_REF02_ISSR_ASSGND_POLCY_ID_OVL_HLTG_INSR_POLCY_NR
L2100REFExchange Assigned APTC Contributor/Tax Payer Identifier
L2100REF02Personal Identification Number (PIN)L2100_S08_REF02_APTC_TAX_PAYR_ID_OVL_PIN
L2100REFIssuer Assigned APTC Contributor/Tax Payer Identifier
L2100REF02Client NumberL2100_S09_REF02_ISSR_ASSGND_APTC_TAX_PAYR_ID_OVL_CLNT_NR
L2100REFExchange Assigned Dependent Identifier
L2100REF02Centers for Medicare and Medicaid Services Plan IDL2100_S10_REF02_UNQ_HLTH_PLAN_ID_OVL_MDCR_MDCD_PLAN_ID
L2100REFIssuer Assigned Dependent Identifier
L2100REF02Member Identification NumberL2100_S11_REF02_ISSR_ASSGND_DEP_ID_OVL_MEM_ID_NR
L2100REFIssuer Assigend Subscriber Identifier
L2100REF02Subscriber NumberL2100_S12_REF02_ISSR_ASSGND_SUB_ID_OVL_SUB_NR

2300 - Remittance Detail

LoopSegmentSegment NameChiapas Gate Mapping
L2300RMRRemittance Detail
L2300RMR01Reference Identification QualifierL2300_S01_RMR01_REF_ID_QUAL
L2300RMR02Exchange Payment TypeL2300_S01_RMR02_EXCHG_PMT_TYP
L2300RMR04Payment AmountL2300_S01_RMR04_PMT_AMT
L2300REFExchange Report Document Control Number
L2300REF02Attached ToL2300_S02_REF02_EXCHG_RPT_TYP_OVL_ATTCHD_TO
L2300DTMIndividual Coverage Period
L2300DTM05Date Time Period Format QualifierL2300_S03_DTM05_DT_TM_PERD_FORMT_QUAL
L2300DTM06Coverage PeriodL2300_S03_DTM06_COVG_PERD