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TRICARE Systems Manual 7950.3-M, April 1, 2015
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:
1  For Header Type Indicator 0 or 9, Batch/Voucher CLIN/ASAP Account Number can only be zero filled.
2  For Header Type Indicator 5 or 6, contractor must have “opened” CLIN/ASAP Accounts with DHA, Contract Resource Management (CRM) per Section G.II of the contract.
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 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), DHA will assign an eight digit 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:
1  Required for TRICARE Mail Order Pharmacy (TMOP) and TPHARM MOP records only, must be zero filled for all others.
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:
1  Contractor must leave this field blank. Data will be populated and maintained by DHA.
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:
1  Contractor must leave this field blank. Data will be populated by DHA.
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:
1  Must be zero filled for Provider file batch header records.
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
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