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TMSIS Dataguide Medicaid.gov
Version 3.27.0

HEALTH-HOME-ENTITY-NAME

Data Element

DE Number

CLT161

System DE Number

CLT.002.161

File Name

CLT - CLAIM LONG-TERM CARE

File Segment Number

CLT00002

File Segment Name

CLAIM-HEADER-RECORD-LT

Last updated

Overview Valid Values Related Rules Related DQ Measures Other Instances
Definition A free-form text field to indicate the health home program that authorized payment for the service on the claim or to identify the health home SPA in which an individual is enrolled. The name entered should be the name that the state uses to uniquely identify the team. A "Health Home Entity" can be a designated provider (e.g., physician, clinic, behavioral health organization), a health team which links to a designated provider, or a health team (physicians, nurses, behavioral health professionals). Because an identification numbering schema has not been established, the entities' names are being used instead.
Size X(50)
FLF Start Position 1017
FLF Stop Position 1066
Segment Key Field Identifier Not Applicable
Coding Requirements 1. Value must not contain a pipe or asterisk symbols
2. Value must 50 characters or less
3. Conditional
Valid Value Code Set Valid Value Code Valid Value Name Valid Value Description Effective Start Date Effective End Date
DE Number System DE Number DE Name File Segment Number File Segment Name
CIP214 CIP.002.214 HEALTH-HOME-ENTITY-NAME CIP00002 CLAIM-HEADER-RECORD-IP
COT138 COT.002.138 HEALTH-HOME-ENTITY-NAME COT00002 CLAIM-HEADER-RECORD-OT
CRX096 CRX.002.096 HEALTH-HOME-ENTITY-NAME CRX00002 CLAIM-HEADER-RECORD-RX
ELG108 ELG.006.108 HEALTH-HOME-ENTITY-NAME ELG00006 HEALTH-HOME-SPA-PARTICIPATION-INFORMATION
ELG119 ELG.007.119 HEALTH-HOME-ENTITY-NAME ELG00007 HEALTH-HOME-SPA-PROVIDERS