EDI 820 File Format For Reconciliation
Before uploading an EDI 820 file, you need to ensure that the EDI 820 file contains the following columns:
Tag | Attribute | Description | Mandatory (Yes or No) |
---|---|---|---|
Algo Param | Account Identifier Type | Used to specify the account identifier type. The valid values
are:
|
Yes (Conditional) Note: This data is required when Account
Identifier is provided.
|
N1[3] | Account Identifier value | Used to specify the value of the account identifier type. | Yes (Conditional) Note: This data is required when Account
Identifier Type is provided.
|
Batch Param | Member Identifier type | Used to specify the member identifier type. | Yes |
RMR[2] | Policy Number | Used to specify the policy number of the member. | Yes |
Algo Param | Plan Number | Used to specify the plan number of the member. | No |
ENT[4] | Member Identifier Value | Used to specify the value of the member identifier type. | Yes |
RMR[4] | Amount | Used to specify the amount that has to be paid to the member. | Yes Note: The data value of this column must be 0, if no amount
is provided.
|
DTM[6] | Coverage Start Date | Used to specify the date of the policy from where the coverage
starts. Note: The Coverage Start Date cannot be later than the coverage
end date.
|
Yes |
DTM[6] | Coverage End Date | Used to specify the date of the policy till when the coverage
ends. Note: The coverage end date cannot be earlier than the coverage
start date.
|
Yes |
NM1[4][5] | Member Name | Used to specify the name of the member. | Yes |
REF[2] | Plan Number | Used to specify the plan number of the member. | Yes (Conditional) Note: This data is required when Algo Param
tag does not have a value.
|
Batch Param | Reconciliation Type | Used to specify the type of reconciliation. | Yes |
Batch Param | Reconciliation Cancel Status | Used to specify the Reconciliation Cancelation status. | Yes |