Technical Interface Guidelines


Health Plan Interface

Third Party Leads Submissions File Layout

DATA NAME

TYPE

SIZE

REMARKS

HEADER RECORD

File Date X 8 (ccyymmdd)
REQUIRED
Health Plan Id Number X 6 REQUIRED
Filler X 369  

DETAIL RECORD

Transaction Type X 1

A – Add
C – Change
T - Termination
REQUIRED

Activity Date X 8

(ccyymmdd)
REQUIRED

Member Last Name X 17 REQUIRED
Member First Name X 12 REQUIRED
Member Middle Initial X 1  
Gender X 1

M=Male, F=Female
REQUIRED

Social Security No X 9  
AHCCCS ID X 10 REQUIRED
Date of Birth X 8

(ccyymmdd)
REQUIRED

Date of Death X 8

(ccyymmdd)

Insured Relation to Client X 3

Relationship to policy holder
   A-Absent Parent
   C-Child
   G-Guarantor
   L-Legal Guardian
   O-Other
   P-Parent
   S-Self

Carrier Name X 36 REQUIRED
Carrier Street 1 X 40  
Carrier Street 2 X 40  
Carrier City X 30  
Carrier State X 2  
Carrier ZIP X 9  
Carrier Phone X 10  
Policy Number X 20 REQUIRED if no Insured SSN
Group Number X 20  
Policy Begin Date X 8 (ccyymmdd)
Policy End Date X 8 (ccyymmdd)
Filler X 3  
Insured Last Name X 17 REQUIRED
Insured First Name X 12 REQUIRED
Insured Middle Initial X 1  
Insured SSN X 9 REQUIRED if no Policy Number
Insured Employer X 40  

TRAILER RECORD

Number of Records X 5 REQUIRED
Filler X 378