File Naming Conventions
- File Naming Convention for HIPAA ANSI 4010A1 837
- File Naming Convention for HIPAA 4010A1 276
- Retrieving 277s
- 277 File Naming Convention
- Retrieving Remittances
- Remittance File Naming Convention
- Retrieving Audit Trails
- Audit Trail File Naming Convention
- Human Readable Audit Trail File Name
- Retrieving Daily Logs
- Daily Log Naming Convention
- Retrieving 997s
- 997 File Naming Convention
File Naming Convention for HIPAA ANSI 4010A1 837
Files for ANSI 4010 837 must use the following naming convention using all UPPER CASE or all lowercase characters:
[(P)roduction or (T)est..State code (p)rofessionalnnnn.extension(clm)]
PGAP0001.CLM or pgap0001.clm
PALP0764.CLM or palp0764.clm
Once compressed, files should be named as follows:
PGAP0001.ZIP or pgap0001.zip
File Naming Convention for HIPAA 4010A1 276
Files for ANSI 4010A1 276 must use the following file naming convention using all UPPERCASE or all lowercase:
[(P)roductionStateCode(B)nnnn.276]
PGAB0001.276 or pgab0001.276
Once compressed the files should be named as follows:
PGAB0001.ZIP or pgab0001.zip
Retrieving 277s
277s are files issued in response to a valid 276 (claim status request) from a submitter. The 277 will give the status of each claim requested in the 276.
277 File Naming Convention
The file naming convention for 277s is:
[signon].[file processed date].[claim type].2774010.zip
where:
[signon] = user ID [file processed date] = date file was processed
[claim type] = Medicare Part B state code (ppbal, ppbga, ppbms) cycle number (will always be 1)
Example: gaf12345.20050511.ppbga1.2774010.zip
This file will unzip to:
gaf12345.20050511.ppbga1.2774010
Retrieving Remittances
Payments for providers are generated every night, Monday - Friday. Electronic Remittance Advice (ERA) files are available the following business day. For example, a remittance created during the Monday night payment cycle would be available to download from the FTP server on Tuesday.
Remittance File Naming Convention
Files are named as follows:
[signon].[date].[claimtype].[format].zip
where,
[signon] = the user ID
[date] = the date of the remittance
[claimtype] = ‘ppbal1’ for Alabama Medicare Part B, 'ppbga1' for Georgia Medicare Part B, ppbms1 for Mississippi Medicare Part B
[format] = 8354010 for ANSI version 4010A1 835.
Example: gaf12345.20050329.ppbga1.8354010.zip, which will unzip to gaf12345.20050329.ppbga1.8354010.
Retrieving Audit Trails
Audit Trail files are available the following business day. For example, Audit Trails would be available to download from the server on Tuesday for files transmitted before 4:30 pm Eastern Time Monday. There are two different versions of the audit trail report. One is formatted to be easier for vendors to write a program that will parse the report and process it automatically. The other is formatted to be human-readable. Both of these reports are created automatically and contain the same data.
Audit Trail File Naming Convention
Below are the formats for audit trail file names.
Machine Readable Audit Trail File Name
[signon].[date].[production or test][cycle number].audcorp.zip
where,
[signon] = your user ID
[date] = the date of the Audit Trail
[production or test] = 'p' or 't'
[cycle number] = number of cycle producing report (since there is only one nightly cycle will always be 01)
Example: gaf12345.20050329.p01.audcorp.zip, which will unzip to gaf12345.20050329.p01.audcorp.
Human Readable Audit Trail File Name
The file name for the human-readable report will be identical to the machine-readable one except the report name will be audrept. For the above example, the human-readable report name will be:
Example: gaf12345.20050329.p01.audrept.zip, which will unzip to gaf12345.20050329.p01.audrept.
Retrieving Daily Logs
Daily logs are text files that indicate if a file was unzipped successfully and if it passed through the 997 and Implementation Guide (IG) edits. The daily log is usually available within two hours after a file has been sent.
Daily Log Naming Convention
The file naming convention for the daily logs is:
[signon].[file processed date]
where
[signon] = the user ID
[file processed date] = the date the file was processed by our system
Example: gaf12345.20050413
Retrieving 997s
997s indicate if a file passed successfully through the first or second levels of ANSI 4010A1 edits. Consult the appendices of any of the implementation guides available from the Washington Publishing Company for the specifications of the 997 report.
997 File Naming Convention
The file naming convention for the 997s is:
[signon].[filename].[file processed date].[file processed time].x997
where
[signon] = the user ID
[file processed date] = the date the file was processed by our system
[file processed time] = the time the file was processed
Example: GAF12345.PGAP0001.20050421.130040.X997
