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First Health Services Corporation

Interface Standards • Revised • Checkboxes

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Section Title Here

	Subsystem	Type	Component	Component Name	Included?
	Subsystem	Type	Component	Component Name	Included?
	Automated Mailing	File	AM-F-004	Automated Mailing Label Text File	Included
	Claims	File	CP-F-010	Electronic Encounter Error File	Included
	Conversion	File	CP-F-914	Medicaid Ancillary Claim Invoice	Included
	Claims	Report	CP-O-025	EMC HCFA Error Report	Not Included
	Claims	Screen	CP-S-004-06-02	PA/Claims Edit Result Screen	Not Included
	Claims	Screen	CP-S-008-04	CHIRP Online Adjustment Segments	Included
	Financial	Report	FN-O-106	Void Claim/Financial Report	Included
	Provider	File	PS-F-802	IRP Provider Specialty Information Extract	Not Included
	Provider	Report	PS-O-005	Provider Applications Pending	Included
	Reference	File	RF-F-LT2	Letters With 132 Characters Per Line	Included

Total Records: 10

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