HCFA AUDIT RULES (Field 11)

Forms must be keyed in all CAPITAL LETTERS.
  
“Key what you see” means to literally key what you see. You are trying to replicate the form as it was submitted; you cannot fix errors.

Field No	HCFA	COMMON VALUES	RULE
11	H11_Insureds_Policy_No		Key what you see.
11	H11a_Insured_Birthdate		Hyphens, spaces, periods and slashes are optional. If the year is four digits, set four digits. If the year is two digits, set two digits. If the month or day is NOT two digits, either add a zero to make it two digits or add hyphens, spaces, periods or slashes. Date fields should NOT contain alphabetic characters. If a date is spelled out (e.g., May 1, 1984), change it to numbers. If any text appears in the field (e.g., STILL IN), do NOT key.

 

 Example :

As it appears on form:	Acceptable entries:
02/04/1972	02/04/1972	02-04-1972	02 04 1972	02.04.1972	02041972
1 08 69	1/08/69	1-08-69	1 08 69	1.08.69	010869
May 1, 1984	5/1/1984	5-1-1984	5 1 1984	5.1.1984	05011984

HCFA AUDIT RULES (Field 10)

Forms must be keyed in all CAPITAL LETTERS.
  
“Key what you see” means to literally key what you see. You are trying to replicate the form as it was submitted; you cannot fix errors.

Field No	HCFA	COMMON VALUES	RULE
10	H10a_Employment_MS	Only allowed values: Y N	Y=Yes   N=No
10	H10b_Auto_Accident	Only allowed values: Y N	Y=Yes   N=No
10	H10b_Place	Two digit state abbreviation	Key what you see.
10	H10c_Other_Accident	Only allowed values: Y N	Y=Yes   N=No

HCFA AUDIT RULES (Field 9)

Forms must be keyed in all CAPITAL LETTERS.
  
“Key what you see” means to literally key what you see. You are trying to replicate the form as it was submitted; you cannot fix errors.

 

Field No	HCFA	COMMON VALUES	RULE
9	H09_Other_Insured_Name		Key what you see.

 
Example :

As it appears on form:	As it should be entered:
Smith, John A.	SMITH, JOHN A.	Key in all caps
SMITH, JOHN, A,	SMITH, JOHN, A,	Key all punctuation as it appears
SMITH,JOHN	SMITH,JOHN	Do not add space around comma
JOHN SMITH	JOHN SMITH	Do not change order of names
DR. JOHN SMITH	DR. JOHN SMITH	Include titles
SAME	SAME	If it says SAME, key SAME
JOHN SMITHJR	JOHN SMITHJR	You cannot fix errors; do not add space before Jr

HCFA AUDIT RULES (fIELD 8)

Forms must be keyed in all CAPITAL LETTERS.
  
“Key what you see” means to literally key what you see. You are trying to replicate the form as it was submitted; you cannot fix errors.

Field No	HCFA	COMMON VALUES	RULE
8	H08_Patient_Married_Status	Only allowed values: S M O	S=Single   M=Married   O=Other
8	H08b_Patient_Employment_Status	Only allowed values: E P F	E=Employed   P=Part time   F=Full time