AHCCCS Technical Interface Guidelines (TIG)

 

Behavioral Health Interface - Recipient Daily Match Response File Layout


The BHS Recipient Daily Match Response File is produced by AHCCCS on a daily basis (Monday through Friday) after processing of the BHS Recipient Daily Match Input File. The BHS Recipient Daily Match Response File will provide ADHS information regarding each input file member's match to an AHCCCS record, eligibility information and current health plan enrollment if matched.

FIELD NAME TYPE SIZE DESCRIPTION
AHCCCS-ID X 9 Client's AHCCCS ID (from BHS Request)
LAST-NAME X 20 Client's Last Name (from BHS Request)
FIRST-NAME X 10 Client's First Name (from BHS Request)
MIDDLE X 1 Client's Middle Initial (from BHS Request)
DATE-OF-BIRTH X 8 Client's Date of Birth (from BHS Request)
SEX-CODE X 1 Client's Gender (from BHS Request)
BHMIS-ID X 10 Client's BHS MIS ID (from BHS Request)
SSN X 9 Client's SSN (from BHS Request)
MHS-CATEGORY X 1 Client's MHS Category (from BHS Request)
SITE X 2 Client's RBHA Site (from BHS Request)
ACTION-CODE X 1 Action Code (from BHS Request)
CASE-MGR-ID X 5 Client's Case Manager (from BHS Request)
BEGIN-DATE X 8 Client's Begin Date (from BHS Request)
END-DATE X 8 Client's End Date (from BHS Request)
INTAKE-DATE X 8 Client's Intake Date (from BHS Request)
CHG-RSN X 2 Client's Change Reason (from BHS Request) or
When MATCHED-IND = X this will be the FYI Change reason or demo change reason
MATCHED-IND X 1 Matched to PMMIS Indicator:
  • M-Matched
  • N-Not Matched
  • P-Partial Matched
  • Blank-Match not attempted
  • X-AHCCCS generated activity
GEN-MSG-CD X 2 General Message code (See table 1 below)
Indicates if request was accepted or rejected
CORRECT-AHCCCS-ID X 9 Member's correct AHCCCS ID
(supplied if submitted AHCCCS ID is secondary or blank)
MEDICARE-PT-A X 1 Member's Medicare Part A status:
  • Y-Medicare Part A eligible
  • N-Not Medicare Part A eligible
MEDICARE-PT-B X 1 Member's Medicare Part B status:
  • Y-Medicare Part B eligible
  • N-Not Medicare Part B eligible
ELIG-FLAG X 1 Flag to indicate eligibility:
  • Y-Member has eligibility
  • N-Member does not have eligibility
MSG-CD-1 X 2 Detail Message Code for FYI Segment 1
See Table 2 below
FYI-BEG-DAT-1 X 8 Begin Date of FYI Segment 1
FYI-END-DAT-1 X 8 End Date of FYI Segment 1
FUND-GRP-1 X 3

Eligibility Funding Group code 1:

  • T19-Title 19
  • T21-Title 21 KidsCare
  • HI-Title 21 HIFA Parent
  • DD-LTC DD enrolled
  • SDI-SSDI/TMC eligible
MSG-CD-2 X 2 Detail Message Code for FYI Segment 2
See Table 2 below
FYI-BEG-DAT-2 X 8 Begin Date of FYI Segment 2
FYI-END-DAT-2 X 8 End Date of FYI Segment 2
FUND-GRP-2 X 3 Eligibility Funding Group code 2:
  • T19-Title 19
  • T21-Title 21 KidsCare
  • HI-Title 21 HIFA Parent
  • DD-LTC DD enrolled
  • SDI-SSDI/TMC eligible
MSG-CD-3 X 2 Detail Message Code for FYI Segment 3 See Table 2 below
FYI-BEG-DAT-3 X 8 Begin Date of FYI Segment 3
FYI-END-DAT-3 X 8 End Date of FYI Segment 3
FUND-GRP-3 X 3 Eligibility Funding Group code 3:
  • T19-Title 19
  • T21-Title 21 KidsCare
  • HI-Title 21 HIFA Parent
  • DD-LTC DD enrolled
  • SDI-SSDI/TMC eligible
MSG-CD-4 X 2 Detail Message Code for FYI Segment 4
See Table 2 below
FYI-BEG-DAT-4 X 8 Begin Date of FYI Segment 4
FYI-END-DAT-4 X 8 End Date of FYI Segment 4
FUND-GRP-4 X 3 Eligibility Funding Group code 4:
  • T19-Title 19
  • T21-Title 21 KidsCare
  • HI-Title 21 HIFA Parent
  • DD-LTC DD enrolled
  • SDI-SSDI/TMC eligible
MSG-CD-5 X 2 Detail Message Code for FYI Segment 5
See Table 2 below
FYI-BEG-DAT-5 X 8 Begin Date of FYI Segment 5
FYI-END-DAT-5 X 8 End Date of FYI Segment 5
FUND-GRP-5 X 3 Eligibility Funding Group code 5:
  • T19-Title 19
  • T21-Title 21 KidsCare
  • HI-Title 21 HIFA Parent
  • DD-LTC DD enrolled
  • SDI-SSDI/TMC eligible
MSG-CD-6 X 2 Detail Message Code for FYI Segment 6
See Table 2 below
FYI-BEG-DAT-6 X 8 Begin Date of FYI Segment 6
FYI-END-DAT-6 X 8 End Date of FYI Segment 6
FUND-GRP-6 X 3 Eligibility Funding Group code 6:
  • T19-Title 19
  • T21-Title 21 KidsCare
  • HI-Title 21 HIFA Parent
  • DD-LTC DD enrolled
  • SDI-SSDI/TMC eligible
CURR-HP-ID X 6 Member's currently enrolled HP ID

 

 

Message Code Tables

 

General Message Codes
CODE DESCRIPTION UPD?
01 DOB is greater than today N
02 Begin date is greater than today N
03 Begin date is before DOB N
04 End date is before begin date N
05 Change reason required when end date present N
06 Invalid change reason N
07 Invalid gender, must be F or M N
08 Invalid action code, must be A (add), T (term), or I (inactivate) N
09 Term action must have end date N
10 Add action must have begin date N
11 Inactivation must have begin date N
12 Invalid date N
13 No end date with change reason present N
14 Invalid SSN (not numeric) N
15 FYI activity modified (add/change/delete) Y
16 FYI record already existed N
22 No FYI record found for terminations N
26 Demo change / No FYI activity – record added to file Y
27 Required data is missing N
28 Invalid category for DOB N
29 Category or site doesn't match FYI segment N
   
Detail Message Codes
CODE DESCRIPTION UPD?
17 FYI record ended Y
19 FYI record created Y
21 FYI record created from FYI inactivation activity Y
23 FYI Segment inactivated Y
24 FYI activity – FYI record ended Y
25 FYI activity - record added to file Y
29 Category or site doesn't match FYI segment N
30 FYI record inactivated from Secondary ID (linked record) Y
31 FYI record added to Primary ID from Secondary ID (linked record) Y