New York PMPM Confirmed Visit Import

This topic provides instructions and the proper format for the PMPM Confirmed Visit Import flat file interface used to import confirmed PMPM CDPAP visits for NY providers. See PMPM CDPAP Services Billing for full instructions.

  • File must be in CSV format.
  • File must follow the format outlined below.
  • All required fields must have values.

Follow the format below to ensure proper import of the file.

  Field Description Data Type Required Max Length Comments
1 Agency ID Unique ID of the agency in HHAeXchange Number Y 10 Do NOT modify this field. 
2 Office ID Office ID in HHAeXchange Number Y 10 Do NOT modify this field. 
3 Patient Number HHAeXchange Patient Admission ID Text Y 50 Do NOT modify this field. 
4 Schedule Start Time

Format: YYYY-MM-DD HH:MM

Default: [First Day of Billing Month] + 03:00 AM

Example: 2024-08-01 03:00 AM

Date/Time Y 20 Modify as needed.
5 Schedule End Time

Format: YYYY-MM-DD HH:MM

Default: [First Day of Billing Month] + 03:15 AM

Example: 2024-08-01 03:15 AM

Date/Time Y 20 Modify as needed.
6 Visit Start Time

Format: YYYY-MM-DD HH:MM

Default: [First Day of Billing Month] + 03:00 AM

Example: 2024-08-01 03:00 AM

Date/Time S 16  
7 Visit End Time

Format: YYYY-MM-DD HH:MM

Default: [First Day of Billing Month] + 03:15 AM

Example: 2024-08-01 03:15 AM

Date/Time S 16  
8 Caregiver Code Caregiver Code Default: Temp (Caregiver Code: 1000) Text Y 50  
9 Pay Rate Caregiver Pay Rate Code Default: Non Payable Text Y 50  
10 Discipline Default: PA Text Y   Defaults to PA. In the event of an overlap (for example, 24-hour care), then Other (Skilled) is used in place of PA.
11 Primary Contract Name of Contract. A contract with matching name should exist in HHAeXchange. Text Y 50 Defaults to the Patient’s contract. Do NOT modify this field.
12 Primary Service code

Primary Contract service code

Defaults to one of the following based on the TOTAL BILLED HOURS found in Column R (Total_Billed_hours) 2443 = Tier 1, 1-159 Hours 2444 = Tier 2, 160 - 480 Hours 2445 = Tier 3, 481 +

Text Y 50 IMPORTANT: An agency can modify this field IF the specific contract does not follow the universal standards of DOH PMPM tiered codes. The agency can replace this with the equivalent tiered code, created in the Contract Service Code Reference Table.
13 Schedule ID Unique Visit Identifier in HHAeXchange.  Text Y 100 Do not modify this field. 
14 Visit Reason Visit Edit Reason Required because this a manually confirmed visit Default value: Consumer Directed Personal Assistance visit Text S 200 Modify to a valid visit edit reason as needed.
15 Visit Action Visit Edit Action Taken Required because this a manually confirmed visit Default Value: Supervisor approved change Text S 200 Modify to a valid visit edit action taken as needed.
16 Notes Visit Note Default Value: Auto created. This is a PMPM tier visit. Text S 500 Do NOT modify this field
17 Payer Initial HHAeXchange Payer Initial Text S 10 Do NOT modify this field
18 HHAeXchange Patient ID HHAeXchange Patient ID Number S   Do NOT modify this field
19 Total Billed Hours Total Billed Hours from PA discipline service codes only, based on month or time frame selected. This field determines the service code defaulted above. Number S   Do NOT modify this field
20 Total Unbilled Hours Total unbilled Hours from PA discipline service codes only, based on month or time frame selected. Number S   Do NOT modify this field. 
21 Total Hours Total Billed hours + Total Unbilled Hours Number S   Do NOT modify this field. 
22 Patient First Name Patient’s first name in the Provider system  Text S 50 Do NOT modify this field. 
23 Patient Last Name Patient’s last name in the Provider system Text S 50 Do NOT modify this field. 
Status Code Import Status Steps to Resolve
200 Success Visit ID is created in HHAeXchange.
201 Agency ID is required. Need to provide or Correct Data
226 Invalid Agency ID Need to provide or Correct Data
203 Caregiver Code is required. Need to provide or Correct Data
204 Schedule ID is required. Need to provide or Correct Data
205 Pay Rate is required. Need to provide or Correct Data
206 Schedule Start Time is required. Need to provide or Correct Data
207 Schedule End Time is required. Need to provide or Correct Data
208 Office ID is not valid. Need to provide or Correct Data
209 Schedule Start Time cannot be greater than Schedule End Time. Need to provide or Correct Data
210 Patient not active on visit date. SOC or Discharge Date: Visits cannot be imported prior to Patient's SOC date or after Patient's Discharge date. To resolve this, change the Patient's start date or Discharge date to respective import visit
211 Schedule cannot be imported because Patient is not in Active or Discharged status. Patient must be Active on the specific visit date.
212 Patient not found in HHAeXchange. Need to provide or correct data. Patient must exist in system.
213  Visit already exist. Visit has already been created in HHAeXchange.
214 Primary Service code is required. Need to provide or Correct Data
215 Primary Contract Name is required. Need to provide or Correct Data
216 Duplicate Patient found in HHAeXchange. There is no chance of this rejection as import is working based on HHAeXchange unique Patient ID.
217 Caregiver is restricted. No schedule can be created. Need to remove Caregiver Restriction from Caregiver on the Absence/Restriction page.
218 Schedule Duration is 0. The Schedule Duration is 0 because the Start and End times are identical. Provide valid Start and End times to resolve this error.
219 Action Code is Required. Need to provide or Correct Data
220 Reason Code is Required. Need to provide or Correct Data
221 Schedule cannot be greater than 24 hours. Need to provide or Correct Data Difference between the Schedule Start Time and End time should not be equal or greater than 24.
222 Visit Start Time cannot be greater than Visit End Time. Need to provide or Correct Data
223 Primary Service Code is not valid.

Need to provide or Correct Data

Primary Service Code must exists in respective Contract/Payer. Check RTM for Contract/Payer in application.
224 Primary Contract Name is not valid.

Need to provide or Correct Data

Primary contract must exist in the application for a specific provider. Check in the Provider Login > Admin menu > Contract Setup > Search Contract
225 Start Date should be the visit day or the next day of the visit day only.

Need to provide or Correct Data

Start Date and Visit Date must align.
227 {{Column Name}} exceeds max character length of {{Config value}} characters. Need to follow Character length of column as specified in NY PMPM Visit Import (see section above).
228 Invalid format of Schedule Start Time Invalid format of Schedule End Time Invalid format of Visit Start Time Invalid format of Visit End Time

Need to provide or Correct Data

Specified in NY PMPM Visit Import. Refer to the section above.
229 End Date should be the visit day or the next day of the visit day only. Need to provide or Correct Data End Date and Visit Date must align.
230 Agency is not linked with Payer To resolve, link agency with Payer.
231 User ID is not linked for Import User. The data import user is required for visit data import and ensures that the visits are created by the Data Import User. THIS IS INTERNAL AND NO ACTION REQUIRED FROM CLIENT.
232  HHAeXchange PatientID is required. Need to provide or Correct Data
233 Duplicate Primary Service Code Found.

Multiple Service Codes found for same contract with same service code text. Only one Primary service code can exist in respective contract or Payer with same name.

Check RTM for Contract or Payer in application.
234 Caregiver Code is not present in HHAeXchange or belongs to different Office. Enter the valid Caregiver Code and resubmit.

For Internal Patients, check for a valid Caregiver Code.

Check the Caregiver in the application for valid Caregiver Code.
235 Visit Edit Reason Code not found in HHAeXchange.

Visit Edit Reason code must exist for the Payer-Provider combination.

Internal Contracts: Check RTM at Provider level.

Linked Contract: Check RTM at Payer level.
236 Visit Edit Action Taken not found in HHAeXchange.

Visit Edit Action Taken must exists for the Payer-Provider combination.

Internal Contracts: Check RTM at Provider level.

Linked Contract: Check RTM at Payer level.
237 Pay Rate ID is not valid.

Pay Rate ID is not found for a search using Caregiver Code.

 

To check and resolve this, check the RTM Non Payable entry in the Caregiver Pay Code table.

 

Provider Login > Admin > Reference Table Management > Select Caregiver Pay Code in Reference Table dropdown
238 Payer Initial is not valid. Need to provide or Correct Data
241 Application returns message in case of Visit Creation Failure. NO ACTION REQUIRED FROM CLIENT
242 Overlapping shifts are not allowed. Patient cannot have the same duration visit on calendar which was sent in a file. If visit found, interface rejects with Overlapping shifts not allowed.
245 Cannot schedule visit when there is no active contract. There is no active contract or placement between the Payer and Patient.
246 Visit cannot be created when patient is on vacation. Visit Date cannot happen during Patient’s vacation period.
247 Issue of Caregiver Overtime: [Caregiver Over Time]

Need to change the overtime configuration at office level from Admin CP.

Agency login > Admin CP > Office configuration > Search office > Check overtime section
248 Future visits cannot be confirmed. Visit Start/End times sent with future times are not created and the Time Zone is configured at the office level
999 Technical Rejection NO ACTION REQUIRED FROM CLIENT