File Layout

** Comma delimited file format
Position Field Max Length Data Type Required Description
0 Client Id Any Required Source System Client Identifier Number
1 First Name Alpha Required Client's First Name
2 Last Name Alpha Required Client' Last Name
3 Middle Initial 1 Alpha Required Client's Middle Initial
4 Social Security # 9 Numeric Required Client's SSN (no dashes or slashes)
5 Medicaid Id # 30 Alpha Conditional Recommended for clients that currently have Medicaid
6 Payor Id Any Required Source System Payor Id
7 Agency Data 1 200 Any Optional Any data that the agency wants to include.
This will be included in the response file
8 Next Appointment 200 Any Optional Data for the client's next appointment i.e. date, time, proivder, service, etc.
This will be included in the response file
9 Gender 1 Alpha Conditional Client' Gender ('M' or 'F', '01' or '02')
10 Date of Birth 10 Date Conditional Client's Date of Birth (MM/DD/YYYY format)
11 Agency Data 2 200 Any Optional Any data that the agency wants to include.
This will be included in the response file
12 Agency Data 3 200 Any Optional Any data that the agency wants to include.
This will be included in the response file

Fields 4 & 5, or 4, 9 and 10 are required. Either combination of values will suffice.

Two file preparation methods are available.

  1. Query Solution (Preferred Method)
    If the source system is a MS Sql Server or ODBC compliant we have a solution that will allow you to create a query and export the records to the batch eligibilty system. This solution will allow any user that has access to the query software to execute, batch, and send the eligibility request. This solution should be thought of as a one-stop-shop to submit eligibility files.
  2. Delimited File Solution
    Basically, if you already have a system that will generate a comma delimited file per the specified layout this solution is an option.

Both methods will prepare a secure file to upload to our website for processing. Generally, within 24 hours a response file will be posted in a Microsoft Excel format.