Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
F.28 Monthly Medicare Second Payer (MSP) Information Data File
The Monthly MSP Information data file is sent directly to Plans on the first Monday after the
MARx month-end processing completes. This file contains a subset of information to assist Plans
with reconciling payment; the full monthly MSP COB file distributed at the beginning of each
month contains more detail.
F.28.1
Header Record
FIELD NAME SIZE POSITION TYPE COMMENTS
Header Code 8 1-8 CHAR
File/record identification purposes only,
'CMSMSPIH'.
Sending Entity 3 9-11 CHAR Hard Coded as 'MBD'
File Creation Date 8 12-19 ZD CCYYMMDD – Format
Filler 481 20-500 CHAR All spaces
Total Length = 500
F.28.2
Detail Record
FIELD NAME SIZE POSITION TYPE COMMENTS
RRB-HIC-NUM 12 1-12 CHAR Use RRB_HIC_NUM if available; else, use
first 9 bytes mapped to BENE_CAN_NUM;
next 2 bytes mapped to BIC_CD ; 12th byte is
a space
Date of Birth 8 13-20 CHAR CCYYMMDD FORMAT
Gender Code 1 21 CHAR
Direct Mapping: 0 = Unknown, 1 = Male, 2 =
Female
Contract Number 5 22-26 CHAR Direct Mapping
PBP Number 3 27-29 CHAR Direct Mapping
MSP Coverage
Effective Date
8 30-37 INT CCYYMMDD FORMAT
MSP Coverage
Termination Date
8 38-45 INT CCYYMMDD FORMAT
Primary Insurance
Code
COB Contractor
Number
1 46 CHAR
Convert as follows:
12…A (Working Aged)
13…B (ESRD)
43…G (Disabled)
5 47-51 CHAR Direct Mapping
Insurer Name 32 52-83 CHAR Direct Mapping
Insurer Address Line 1 32 84-115 CHAR Direct Mapping
Insurer Address Line 2 32 116-147 CHAR Direct Mapping
Insurer City name 15 148-162 CHAR Direct Mapping
Insurer State Code 2 163-164 CHAR Direct Mapping
Insurer Zip Code 9 165-173 CHAR Direct Mapping
Policy Number 17 174-190 CHAR Direct Mapping
Filler 310 191-500 CHAR Hard Coded as Spaces
Total Length = 500
December 28, 2012 F-142 MSP Information Data File