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Tier | 3.0 |
---|---|
Tier Description | Relational error |
Error Category | E3002 |
Error Category Message | Values inconsistently specified (multiple record types, multi file) |
Rule Type | Two Record Type (1 to 1) |
File Segment Number | ELG00014 |
Data Element Name | MANAGED-CARE-PARTICIPATION.SUBMITTING-STATE • MANAGED-CARE-PARTICIPATION.MANAGED-CARE-PLAN-ID • MANAGED-CARE-PARTICIPATION.MANAGED-CARE-PLAN-ENROLLMENT-EFF-DATE • MANAGED-CARE-PARTICIPATION.MANAGED-CARE-PLAN-ENROLLMENT-END-DATE • MANAGED-CARE-MAIN.MANAGED-CARE-CONTRACT-END-DATE • FILE-HEADER-RECORD-ELIGIBILITY.END-OF-TIME-PERIOD • MANAGED-CARE-MAIN.MANAGED-CARE-CONTRACT-EFF-DATE |
Validation Logic | if MANAGED-CARE-PARTICIPATION has a non-null value for MANAGED-CARE-PLAN-ID and MANAGED-CARE-PARTICIPATION.MANAGED-CARE-PLAN-ENROLLMENT-END-DATE is greater than or equal to 'cutover date', then for every record of type MANAGED-CARE-PARTICIPATION, there must be a valid record of type MANAGED-CARE-MAIN that matches on the join keys and (MAX(MANAGED-CARE-PARTICIPATION.MANAGED-CARE-PLAN-ENROLLMENT-EFF-DATE, null) >= MANAGED-CARE-MAIN.MANAGED-CARE-CONTRACT-EFF-DATE and MANAGED-CARE-PARTICIPATION.MANAGED-CARE-PLAN-ENROLLMENT-END-DATE <= MANAGED-CARE-MAIN.MANAGED-CARE-CONTRACT-END-DATE) |
Rule Definition | If the managed care plan ID is populated on a managed care participation ELG file segment and the managed care participation managed care plan enrollment end date is greater than the states tmsis cutover date then the effective and end dates on the managed care participation segment must fall within the effective and end dates of one or more continuous managed care main segments. |
Denominator Logic | # of MANAGED-CARE-PARTICIPATION segments with MANAGED-CARE-PARTICIPATION has a non-null value for MANAGED-CARE-PLAN-ID and with MANAGED-CARE-PARTICIPATION.MANAGED-CARE-PLAN-ENROLLMENT-END-DATE is greater than or equal to 'cutover date' |