760 IAC 1-83-27 Monthly data file submission requirements

Sec. 27. (a) Submitters shall submit data files monthly through the data portal. A monthly file must be submitted by the first business day of the second month after the report month. (b) The following files, as specified in the data submission guide, in conjunction with the APCD-CDL™, must be submitted: (1) Eligibility files. (2) Medical claims files. (3) Pharmacy claims files. (4) Provider files. (c) Files must exclude data for members only enrolled in the types of coverages set forth in IC 27-1-44.5-2(3)(A) through IC 27-1-44.5-2(3)(H). (d) Data files must comply with file format, technical specifications, and other standards specified in the data submission guide, in conjunction with the APCD-CDLTM. (e) If a submitter has identified at least one (1) designated submitter or designated submitter representative to submit information directly to the data portal on their behalf, the data submission is not considered finished until the required files have been received. (f) Submitters shall use the data portal to submit test files to confirm and test their ability to create data files meeting the standards set forth in the data submission guide. Test files will be identified as specified in the data submission guide. Test files will not be considered to have been submitted to the APCD.