Submissions Archives - CIVHC.org

What power does CIVHC have to compel health plans to comply with the CO APCD reporting requirements?

How should partially denied claims (paid claims containing denied lines) be submitted?

Will gender codes be standardized across all three files?

Does CIVHC expect that the data fields to be submitted in field number order, or, in the logical order given in the Submission Guide?

What is the threshold guidance for column MC107?

What value should appear in the Payer Code columns?

Do Version Numbers ( MC005A) need to be consecutive?

Should only paid and discharged claims be included?

What is the guidance for MC055 (Procedure Code) for institutional claims?

What is the guidance for columns MC065 (Co-pay Amount) and MC066 (Coinsurance Amount)?

What is the guidance for columns marked as O (Optional)?

Should all detail lined be supplied for a paid claim?

What column names should be supplied in the first row?

What are the definitions for MP003 (Provider Entity)?

Values for column MC054 (Revenue Code), a required column, are not available for professional claims. Should we apply for a variance for this deficiency?

What is the guidance for column MC055 (Procedure Code) where payments are made based on Revenue Code?

What is the guidance for MC058 ( ICD-9-CM Procedure Code)?

What is the column delimiter?

Do Colorado license numbers need to be prefixed with the state code?

What is the proper coding for dependents over age 18?

I’m a self-insured, employer-funded health plan regulated by ERISA (“ERISA plan”). Am I required to submit health claims data to the CO APCD?

As an ERISA plan, what happens to the data my ASO/TPA submitted on my behalf prior to the Supreme Court’s March 1, 2016 decision? Will the data be used in public and non-public data releases moving forward?

If I’m another category of payer, not an ERISA plan, can I stop submitting data to the CO APCD?

I’m an ERISA plan. I have not yet submitted any data to the CO APCD and have not submitted an opt-out form. Do I still need to submit an opt-out form and will there be any penalties for my failure to timely submit an opt-out form?

Is there a cost to submit?