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TMSIS Dataguide Medicaid.gov
Version 3.30.0

RULE-3088

Validation Rule
Last updated

No Updates

Tier 1.1
Tier Description Value Error
Error Category E1102
Error Category Message Value does not match specification
Rule Type One Record Type (Single Record)
File Segment Number TPL00003
Data Element Name TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO.INSURANCE-PLAN-ID
Validation Logic 'if TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO has a valid, non-null value for INSURANCE-PLAN-ID, then TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO.INSURANCE-PLAN-ID does not contain any pipe (|) or asterisk (*) characters'
Rule Definition If the insurance plan id is populated on a non-denied claim from an IP file, then the insurance plan id reported must not contain any pipe or asterisk characters.
Denominator Logic # of TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO segments with TPL-MEDICAID-ELIGIBLE-PERSON-HEALTH-INSURANCE-COVERAGE-INFO.INSURANCE-PLAN-ID equal to a valid, non-null value