TRICARE Encounter Data (TED)
Chapter 2
Section 2.3
Data Requirements
- Header Record Data
Revision:
DATA ELEMENT
DEFINITION
ELEMENT NAME: BATCH/VOUCHER CLIN/ASAP ACCOUNT
NUMBER
|
Notes And Special Instructions:
CLIN based CLIN/ASAP Account
Numbers are used for Invoicing (via the TED record) the Cost Reimbursement
Benefit CLINs (positions 1 through 6 of the CLIN/ASAP Account Number
shall equal the benefit contract CLIN or sub-CLIN you are invoicing),
ASAP based CLIN/ASAP Account Numbers are used for the reporting
of ‘pass-through’ costs.
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-025
|
1
|
Yes1
|
Primary Picture (Format)
|
Eight (8) alphanumeric characters.
|
Definition
|
This field is used to identify
the Automated Standard Application for Payment (ASAP) Account Number2 the
voucher will be drawn from. Each year when new non-financially underwritten
bank account(s) are setup by the contractor (per the financial provisions
of the contract), Defense Health Agency (DHA) will assign an eight
digit Contract Line Item Number (CLIN)/ASAP Account Number to draw
funds from as checks clear the non-financially underwritten bank
account(s).
|
Code/Value Specifications
|
N/A
|
Algorithm
|
Section 1.1, paragraph 5.0 provides instructions
on how to assign TED records to the Accrual Fund.
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
VOUCHER NUMBER
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: BATCH/VOUCHER DATE
|
Notes And Special Instructions:
N/A
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-030
|
1
|
Yes
|
Primary Picture (Format)
|
Seven (7) alphanumeric characters,
YYYYDDD.
|
Definition
|
Date the contractor first created
the batch/voucher for transmission to DHA. This date will not change through
the resubmission process.
|
Code/Value Specifications
|
YYYY
|
4 digit calendar year
|
|
DDD
|
3 digit Julian date
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
BATCH/VOUCHER NUMBER
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: BATCH/VOUCHER IDENTIFIER
|
Notes And Special Instructions:
N/A
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-015
|
1
|
Yes
|
Primary Picture (Format)
|
One (1) alphanumeric character.
|
Definition
|
Identifies the type of records
submitted in the batch/voucher.
|
Code/Value Specifications
|
3
|
Provider (Batch Only)
|
|
5
|
Institutional/Non-Institutional
(Batch/Voucher)
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
CONTRACT IDENTIFIER
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: BATCH/VOUCHER NUMBER
|
Notes And Special Instructions:
N/A
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-020
|
1
|
Yes
|
Primary Picture (Format)
|
Group
|
Definition
|
Field containing multiple elements
that uniquely identify the batch/voucher.
|
Code/Value Specifications
|
N/A
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
BATCH/VOUCHER ASAP ACCOUNT
NUMBER
BATCH/VOUCHER DATE
BATCH/VOUCHER
SEQUENCE NUMBER
BATCH/VOUCHER RESUBMISSION
NUMBER
|
CONTRACT IDENTIFIER
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: BATCH/VOUCHER RESUBMISSION
NUMBER
|
Notes And Special Instructions:
N/A
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-040
|
1
|
Yes
|
Primary Picture (Format)
|
Two (2) alphanumeric characters.
|
Definition
|
Identifies the number of submissions
for the batch/voucher.
|
Code/Value Specifications
|
N/A
|
Algorithm
|
Set initial submission batch/voucher
to 00 and increment by one (1) with each resubmission of rejected TED
records. Do not increment if resubmitting a batch/voucher
that failed batch/voucher header edits.
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
BATCH/VOUCHER NUMBER
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: BATCH/VOUCHER SEQUENCE NUMBER
|
Notes And Special Instructions:
Batch/Voucher Sequence Number
will not be duplicated for that date (i.e., once sequence number
01 has been assigned to a batch or voucher it cannot be assigned
to any other batch or voucher for that day).
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-035
|
1
|
Yes
|
Primary Picture (Format)
|
Two (2) alphanumeric characters.
|
Definition
|
A sequential number assigned
by the contractor to uniquely identify the batch/voucher. Once assigned,
the number remains with the batch/voucher throughout the resubmission
process if applicable.
|
Code/Value Specifications
|
N/A
|
Algorithm
|
Set initial sequence number
to 01 and increment by one (1) for each subsequent batch/voucher
for that date. Do not “reuse” sequence number within Contract Identifier
for that date.
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
BATCH/VOUCHER NUMBER
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: CONTRACT IDENTIFIER
|
Notes And Special Instructions:
N/A
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-005
|
1
|
Yes
|
Primary Picture (Format)
|
Group
|
Definition
|
Field containing multiple elements
that uniquely identify each batch/voucher of records submitted by the
contractor.
|
Code/Value Specifications
|
N/A
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
CONTRACT NUMBER
BATCH/VOUCHER
IDENTIFIER
BATCH/VOUCHER NUMBER
|
N/A
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: CONTRACT NUMBER
|
Notes And Special Instructions:
N/A
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-010
|
1
|
Yes
|
Primary Picture (Format)
|
Thirteen (13) alphanumeric
characters.
|
Definition
|
The unique 13 digit contract
number assigned to a contract.
|
Code/Value Specifications
|
N/A
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
CONTRACT IDENTIFIER
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: FUND ACCOUNTING
|
Notes And Special Instructions:
Note: For TMOP records, the FUND
ACCOUNTING must equal the sum of (AMOUNT ALLOWED BY PROCEDURE CODE
minus AMOUNT BILLED BY PROCEDURE CODE) for all included records.
For TPharm MOP records, the
FUND ACCOUNTING must equal the sum of AMOUNT ALLOWED BY PROCEDURE
CODE for all included records for Batch/Voucher Dates on or after
July 14, 2011. FUND ACCOUNTING must be zero for Batch/Voucher Dates
prior to July 14, 2011.
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-065
|
1
|
Yes1
|
Primary Picture (Format)
|
Ten (10) signed numeric digits
including two (2) decimal places.
|
Definition
|
This field contains the total
Government drug cost dollars dispensed by the contractor.
|
Code/Value Specifications
|
N/A
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
N/A
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: HEADER TYPE INDICATOR
|
Notes And Special Instructions:
Contractors are responsible
for ensuring claims are submitted under the correct Header Type
Indicator when billing Administrative CLINs on a TED record. TED
records shall be submitted under the correct Header Type Indicator
in order to receive and retain Administrative CLIN payment(s). Refer
to Section G.II of the contract for guidance on using this field
to invoice Administrative CLINs.
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-001
|
1
|
Yes
|
Primary Picture (Format)
|
One (1) alphanumeric character.
|
Definition
|
Code to indicate whether the
record is a batch header or voucher header, and whether a voucher contains
admin rate eligible records.
|
Code/Value Specifications
|
0
|
Batch Header (used on all provider
batches, and for institutional/non-institutional non-admin claim
rate TED records).
|
|
5
|
Voucher Header (used only for
institutional/non-institutional non-admin claim rate eligible TED
records).
|
|
6
|
Voucher Header (used only for
institutional/non-institutional admin claim rate eligible TED records).
|
|
9
|
Batch Header (institutional/non-institutional
admin claim rate eligible TED records).
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
N/A
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: INITIAL TRANSMISSION DATE (DHA
DERIVED)
|
Notes And Special Instructions:
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-055
|
1
|
Yes1
|
Primary Picture (Format)
|
Eight (8) numeric digits, YYYYMMDD.
|
Definition
|
The Initial Transmission Date
is the date the contractor transmitted the voucher to DHA.
1. Voucher: Once
submission 00 has cleared, the Initial Transmission Received date cannot change, since
this will be the date that DHA obligates the non-financially underwritten
money and the date that will appear on the checks being issued to
the providers/beneficiaries.
2. Batch: This field
will be zero filled.
|
Code/Value Specifications
|
YYYY
|
4 digit calendar year
|
|
MM
|
2 digit calendar month
|
|
DD
|
2 digit calendar day
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
N/A
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: DHA BATCH/VOUCHER PROCESSING
DATE (DHA DERIVED)
|
Notes And Special Instructions:
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-060
|
1
|
No1
|
Primary Picture (Format)
|
Eight (8) numeric digits, YYYYMMDD.
|
Definition
|
The date the batch/voucher
was processed by DHA.
|
Code/Value Specifications
|
YYYY
|
4 digit calendar year
|
|
MM
|
2 digit calendar month
|
|
DD
|
2 digit calendar day
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
N/A
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: TOTAL AMOUNT PAID
|
Notes And Special Instructions:
Note: For MOP Contract MDA906-02-C-0013
records, the TOTAL AMOUNT PAID must equal AMOUNT PAID BY GOVERNMENT
CONTRACTOR BY PROCEDURE CODE for all included records.
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-050
|
1
|
Yes1
|
Primary Picture (Format)
|
Twelve (12) signed numeric
digits including two (2) decimal places.
|
Definition
|
This field contains the total
benefit dollars paid by the contractor and the interest paid for
the TED records contained in either the batch or voucher.
|
Code/Value Specifications
|
N/A
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
N/A
|
DATA ELEMENT
DEFINITION
ELEMENT NAME: TOTAL NUMBER OF RECORDS
|
Notes And Special Instructions:
N/A
|
Records/Locator
Numbers
|
Record Name
|
Locator#
|
Occurrences
|
Required
|
Header
|
0-045
|
1
|
Yes
|
Primary Picture (Format)
|
Seven (7) numeric digits.
|
Definition
|
Total number of records submitted
in the batch or voucher, exclusive of the header and trailer records. (Refer
to Section 2.2, paragraph 5.0.)
|
Code/Value Specifications
|
N/A
|
Algorithm
|
N/A
|
Subordinate And/Or Group Elements
|
Subordinate
|
Group
|
N/A
|
N/A
|
- END -