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					]81ed6b4f-1fca-4409-8f04-0392bdf34d36.xls                       C21 Transactions versions


   NHIC File Extension Naming Convention for Download Files from the ECMS Bulletin Board Service

   The naming convention for downloadabe files on the ECMS BBS is 8.8.3. The first 8 bytes are the ECMS
    assigned batch ID*, the next 8 bytes are ECMS assigned file ID, and the last 3 bytes are the extension.


* Exception: The 8.8 naming convention on 835, Z08, Z04 and 277 (pending remit or CMS claim acivity report)
filesis as follows: first 8 bytes are the ECMS Submitter/Reciever ID, next 8 bytes are the ECMS assigned file ID.

Definitions:
NHIC - National Heritage Insurance Company : Claims administrator for Texas Medicaid
CMS - Claim Management System: NHIC's processing system for Long Term Care transactions
C21 - Compass21- NHIC's processing system for Acute Care , Family Planning and Children with Special Health
Care Needs transactions

TDHConnect -Texas Medicaid proprietary software offered to provider's free of charge for submitting and
receiving electronic transactions
Vendors - Electronic submitter or receiver using any method or product to other than TDHconnect
EBX - NHIC's translation and clearinghouse service
ECMS -(Electronic Commerence Management System (aka EBX)
BCBS - Blue Cross Blue Shield of Texas

            Transaction /File               File Extension                           Comment
                                                              This is the response to the solicited 276 for CMS and
                                                              C21. This file is generated for both TDHconnectand
Health Care Claim Status Inguiry                        277   vendors.
                                                              This is the unsolicited response to claim for CMS
                                                              and C21. This file is generated for TDHconnect
Proprietary Claim response                              Z06   only.
                                                              This the weekly finalized claim remittance for CMS
                                                              and C21 . This file is generated for both TDHconnect
Health Care Claim Payment/ Advise                       835   and vendors.
                                                              This is the weekly pending claim remittance for CMS
                                                              and C21. This file is generated for vendors only. For
                                                              CMS, this file will contain the new Claim Activity
Pending Remittance                                      277   Report.




81ed6b4f-1fca-4409-8f04-0392bdf34d36.xls
]81ed6b4f-1fca-4409-8f04-0392bdf34d36.xls             C21 Transactions versions


                                                   This is the file acknowlegment for CMS and C21.
                                                   This file is produced only on files that reject due to
                                                   not being HIPAA compliant. This file is generated for
Functional Acknowledgment                    997   both TDHconnect and vendors.
                                                   This is the response to the 270 for CMS and C21.
                                                   This file is generated for both TDHconnect and
Eligibility response                         271   vendors.
                                                   This is the unsolicited response to claim for CMS.
X. 12 CMS claim response                    27C    This file is generated for vendors only.
                                                   This is the unsolicited response to claim for C21.
X. 12 C21 claim response                    27S    This file is generated for vendors only.
                                                   This is the weekly pending claim remittance for C21.
Pending Remittance                          Z03    This file is generated for TDHconnect only.

                                                   This is the weekly pending and finalized remittance
                                                   report for CMS. It replaces the pending only report
                                                   that was produced by CMS prior to HIPAA. This file
Claim Activity Report                       Z08    is generated for TDHconnect only.
                                                   This is a CMS supplemental file that contains
                                                   eligibiliby data not covered by HIPAA. This file is
CMS batch proprietary eligibility file      Z01    generated for both TDHconnect and vendors.
                                                   This is a CMS supplemental file that contains claim
                                                   status data not covered by HIPAA. This file is
CMS batch proprietary CSI file              Z13    generated for both TDHconnect and vendors.
                                                   This is a CMS supplemental file that contains
                                                   financial data not covered by HIPAA. This file is
CMS batch proprietary financial file        Z04    generated for both TDHconnect and vendors.

                                                This is a proprietary file rejection that occurred
                                                during the 2nd security phase of the mapping. This
File Rejection                              ZZZ file is generated for both TDHconnect and vendors.
                                                This is a proprietary file rejection that occurred
                                                during the security phase of the mapping. This file is
File Rejection                              XER generated for both TDHconnect or a vendor.
                                                This is a readable report generated by EBX that
                                                indicated accepted transactions. This file will be
Accept Report                               ACC received by TDHconnect or a vendor.



81ed6b4f-1fca-4409-8f04-0392bdf34d36.xls
]81ed6b4f-1fca-4409-8f04-0392bdf34d36.xls           C21 Transactions versions


                                                This is a readable report generated by EBX that
                                                indicated rejected transactions. This file is
Rejected Report                             REJ generated for both TDHconnect and vendors.
                                                This is an extract report generated by EBX that tells
                                                indicates both accepted and rejected transactions.
                                                This file will be received by TDHconnect and
Extract Accept/Reject Report                EXT vendors.
                                                This is a proprietary response for BCBS and
                                                Medicare claims. This file is generated for
NHIC Clearinghouse responses                Z44 TDHconnect only.




81ed6b4f-1fca-4409-8f04-0392bdf34d36.xls

				
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