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VALIDITY
EDITS
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Relational
Edits
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2-055-11F
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• TPR
[SERVICE MEMBER]
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IF HEADER TYPE
INDICATOR =
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5
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VOUCHER HEADER NON-ADMIN CLAIM
RATE-ELIGIBLE OR
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6
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VOUCHER HEADER ADMIN CLAIM
RATE-ELIGIBLE
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AND ENROLLMENT/HEALTH
PLAN CODE =
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W
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TPR SERVICE MEMBER - USA OR
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WA
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TPR FOREIGN SERVICE MEMBER
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OR ANY OCCURRENCE
OF SPECIAL PROCESSING CODE =
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GU
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SERVICE MEMBER ENROLLED IN
TPR
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AND TYPE OF SUBMISSION
≠
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B
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ADJUSTMENT TO NON-TED RECORD
(HCSR) DATA OR
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E
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COMPLETE CANCELLATION OF NON-TED
RECORD (HCSR) DATA
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AND THE TOTAL
OF ALL OCCURRENCES/LINE ITEMS OF AMOUNT PAID BY GOVERNMENT CONTRACTOR
BY PROCEDURE CODE ≠ ZERO
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THEN SERVICE BRANCH
CLASSIFICATION CODE (SPONSOR) MUST =
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A
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ARMY OR
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C
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COAST GUARD OR
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F
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AIR FORCE OR
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H
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PHS OR
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M
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MARINES OR
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N
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NAVY OR
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O
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NOAA OR
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Z
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NOT PROVIDED FROM DEERS
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AND HCC MEMBER
CATEGORY CODE
MUST =
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A
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ACTIVE DUTY OR
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G
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NATIONAL GUARD MEMBER (MOBILIZED
OR ON ACTIVE DUTY FOR 31 CALENDAR DAYS OR MORE) OR
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J
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ACADEMY STUDENT OR
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N
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NATIONAL GUARD MEMBER (NOT
ON ACTIVE DUTY OR ON ACTIVE DUTY FOR 30 CALENDAR DAYS OR LESS) OR
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S
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RESERVE MEMBER (MOBILIZED OR
ON ACTIVE DUTY FOR 31 CALENDAR DAYS OR MORE) OR
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V
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RESERVE MEMBER (NOT ON ACTIVE
DUTY OR ON ACTIVE DUTY FOR 30 CALENDAR DAYS OR LESS) OR
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Z
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UNKNOWN
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AND HCC MEMBER
RELATIONSHIP CODE MUST =
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A
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SELF OR
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Z
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UNKNOWN
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2-055-20F
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• SHCP
VOUCHERS (SERVICE MEMBER CLAIMS ONLY)
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IF ENROLLMENT/HEALTH
PLAN CODE =
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SR
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SHCP - MTF/MARKET REFERRED
CARE (EFFECTIVE
10/01/1999)
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OR ANY OCCURRENCE
OF SPECIAL PROCESSING CODE =
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AR
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SHCP - MTF/MARKET REFERRED
CARE
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OR TYPE OF SUBMISSION
=
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B
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ADJUSTMENT TO NON-TED RECORD
(HCSR) DATA OR
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E
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COMPLETE CANCELLATION OF NON-TED
RECORD (HCSR) DATA
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OR AMOUNT PAID
BY GOVERNMENT CONTRACTOR (TOTAL) = ZERO
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THEN BYPASS THIS
EDIT
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ELSE IF HEADER
TYPE INDICATOR =
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5
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VOUCHER HEADER NON-ADMIN CLAIM
RATE-ELIGIBLE OR
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6
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VOUCHER HEADER ADMIN CLAIM
RATE-ELIGIBLE
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AND ENROLLMENT/HEALTH
PLAN CODE =
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X
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FOREIGN SERVICE MEMBER OR
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SO
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SHCP - NON-TRICARE ELIGIBLE OR
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ST
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SHCP - TRICARE ELIGIBLE OR
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SU
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SHCP - REFERRAL DESIGNATION
UNKNOWN
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OR ANY OCCURRENCE
OF SPECIAL PROCESSING CODE =
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AD
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FOREIGN ACTIVE DUTY CLAIMS
(EFFECTIVE
06/30/1996) OR
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CE
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SHCP - CCEP OR
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SC
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SHCP - NON-TRICARE ELIGIBLE OR
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SE
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SHCP - TRICARE ELIGIBLE OR
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SM
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SHCP - EMERGENCY
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THEN SERVICE BRANCH
CLASSIFICATION CODE (SPONSOR) MUST =
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A
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ARMY OR
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C
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COAST GUARD OR
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F
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AIR FORCE OR
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H
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PHS OR
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M
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MARINES OR
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N
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NAVY OR
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O
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NOAA OR
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Z
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NOT PROVIDED FROM DEERS OR
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1
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FOREIGN ARMY OR
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2
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FOREIGN NAVY OR
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3
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FOREIGN MARINE CORPS OR
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4
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FOREIGN AIR FORCE
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AND HCC MEMBER
CATEGORY CODE MUST =
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A
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ACTIVE DUTY OR
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G
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NATIONAL GUARD MEMBER (MOBILIZED
OR ON ACTIVE DUTY FOR 31 CALENDAR DAYS OR MORE) OR
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J
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ACADEMY STUDENT OR
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N
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NATIONAL GUARD MEMBER (NOT
ON ACTIVE DUTY OR ON ACTIVE DUTY FOR 30 CALENDAR DAYS OR LESS) OR
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S
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RESERVE MEMBER (MOBILIZED OR
ON ACTIVE DUTY FOR 31 CALENDAR DAYS OR MORE) OR
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T
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FOREIGN MILITARY MEMBER OR
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V
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RESERVE MEMBER (NOT ON ACTIVE
DUTY OR ON ACTIVE DUTY FOR 30 CALENDAR DAYS OR LESS) OR
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Z
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UNKNOWN
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AND HCC MEMBER
RELATIONSHIP CODE
MUST =
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A
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SELF OR
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Z
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UNKNOWN
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2-055-32F
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• SHCP
- NON-MTF/MARKET REFERRED VOUCHER (SERVICE MEMBER CLAIMS ONLY)
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IF TYPE OF SUBMISSION
=
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B
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ADJUSTMENT TO NON-TED RECORD
(HCSR) DATA OR
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E
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COMPLETE CANCELLATION OF NON-TED
RECORD (HCSR) DATA
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OR AMOUNT PAID
BY GOVERNMENT CONTRACTOR (TOTAL) = ZERO
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THEN BYPASS THIS
EDIT
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ELSE IF HEADER
TYPE INDICATOR =
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5
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VOUCHER HEADER NON-ADMIN CLAIM
RATE-ELIGIBLE OR
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6
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VOUCHER HEADER ADMIN CLAIM
RATE ELIGIBLE
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AND ENROLLMENT/HEALTH
PLAN CODE =
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SN
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SHCP - NON-MTF/MARKET REFERRED
CARE
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OR ANY OCCURRENCE
OF SPECIAL PROCESING CODE =
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AN
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SHCP - NON-MTF/MARKET REFERRED
CARE
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THEN SERVICE BRANCH
CLASSIFICATION CODE (SPONSOR) MUST =
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A
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ARMY OR
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C
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COAST GUARD OR
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F
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AIR FORCE OR
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H
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PHS OR
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M
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MARINES OR
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N
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NAVY OR
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O
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NOAA OR
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Z
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NOT PROVIDED FROM DEERS OR
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1
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FOREGIN ARMY OR
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2
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FOREIGN NAVY OR
|
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3
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FOREIGN MARINE CORPS OR
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4
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FOREIGN AIR FORCE
|
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AND HCC MEMBER
RELATIONSHIP CODE MUST =
|
A
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SELF OR
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Z
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UNKNOWN
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