Transcription of NCPDP REFERENCE MANUAL - CMS
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NCPDP REFERENCE MANUAL - CMS
Rev. 2005-4/October 3-1 2002 VIPS, Inc. All Rights Reserved. Use or disclosure of the information contained on this page is subject to the restrictions on the title page of this material. Chapter 3: NCPDP Flat File Format About the Flat File Format (FFF) File Layout The Health Insurance Portability & Accountability Act of 1996 (HIPAA) requires that a single standard be used for the electronic submission of retail pharmacy claims NCPDP format. These incoming claims are first passed through an NCPDP translator and stored in a Flat-File-Format (FFF). ViPS programs pass the FFF data through a series of editing programs and produce reports that list the claims included in the transmission and identify any errors in the submitted data. The process then formats the FFF file into the Claims-In-Process (CIP) format used by the VMS subsystems and the Certificate of Medical Necessity (CMN) format used for DME.
Sender ID* 880-K1 Identification number assigned to the sender of the data by the processor of the data. X(24) NCPKFLAT 1 24 Segment Identifier*2 701 Unique record type required on Batch Transaction Standard. X(02) 01 = ViPS Segment NCPKFLAT 25 26 Segment Identification* 111-AM Identifies the segment in the request record. This field is only ...
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