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TMSIS Dataguide Medicaid.gov
Version 3.28.0

RULE-2820

Validation Rule
Last updated

Tier 2.1
Tier Description Relational error
Error Category E2102
Error Category Message Values inconsistently specified (multi record, single file)
Rule Type Three Record Type Rule
File Segment Number PRV00002
Data Element Name PROV-ATTRIBUTES-MAIN.DATE-OF-BIRTH • FILE-HEADER-RECORD-PROVIDER.START-OF-TIME-PERIOD
Validation Logic 'if PROV-ATTRIBUTES-MAIN has a non-null and not invalidly formatted value for DATE-OF-BIRTH and FILE-HEADER-RECORD-PROVIDER has a non-null and not invalidly formatted value for START-OF-TIME-PERIOD and FILE-HEADER-RECORD-PROVIDER has a non-null and not invalidly formatted value for END-OF-TIME-PERIOD and PROV-ATTRIBUTES-MAIN has a null value for DATE-OF-DEATH and PROV-MEDICAID-ENROLLMENT.PROV-MEDICAID-ENROLLMENT-STATUS-CODE is not equal to one of the following: '60', '61', '62', '63', '64', '65', '66', '67', '68', '69', '70', '71', '72', '73', '74', '75', '76', '77', '78', '79', '80', '81', '82', '83', then the difference between dates PROV-ATTRIBUTES-MAIN.DATE-OF-BIRTH and FILE-HEADER-RECORD-PROVIDER.START-OF-TIME-PERIOD is less than or equal to 85 years and the difference between dates PROV-ATTRIBUTES-MAIN.DATE-OF-BIRTH and FILE-HEADER-RECORD-PROVIDER.START-OF-TIME-PERIOD is greater than or equal to 18 years'
Rule Definition If the provider attributes main segment has a value populated for date of birth and the provider file header segment has a value populated for start of time period, and the date of death is not populated in the provider attributes main segment and the provider Medicaid enrollment status is not terminated then the difference between the date of birth and start of time period values is less than or equal to 85 years and greater than or equal to 18 years.
Denominator Logic # of PROV-ATTRIBUTES-MAIN segments with PROV-ATTRIBUTES-MAIN.DATE-OF-BIRTH equal to a valid, non-null value and with FILE-HEADER-RECORD-PROVIDER.END-OF-TIME-PERIOD equal to a valid, non-null value and with FILE-HEADER-RECORD-PROVIDER.START-OF-TIME-PERIOD has a valid, non-null value FILE-HEADER-RECORD-PROVIDER has a non-null and not invalidly formatted value for END-OF-TIME-PERIOD and for every record of type PROV-ATTRIBUTES-MAIN there must be a valid record of type PROV-MEDICAID-ENROLLMENT that matches on join keys and with PROV-ATTRIBUTES-MAIN.DATE-OF-DEATH equal to a null value and with PROVIDER-MEDICAID-ENROLLMENT-STATUS-CODE not in: '60', '61', '62'. '63', '64', '65', '66', '67', '68'. '69', '70', '71', '72', '73', '74', '75', '76', '77', '78', '79', '80', '81', '82', '83'.