Florida Administrative Code
59 - AGENCY FOR HEALTH CARE ADMINISTRATION
59B - Cost Management and Control
Chapter 59B-9 - PATIENT DATA COLLECTION, AMBULATORY SURGERY AND EMERGENCY DEPARTMENT
Section 59B-9.037 - Header Record

(1) Report Year. Enter the year of the data in the format YYYY.

(2) Report Quarter. Enter the quarter of the data, 1, 2, 3 or 4, where 1 corresponds to the first quarter of the calendar year, 2 corresponds to the second quarter of the calendar year, 3 corresponds to the third quarter of the calendar year, and 4 corresponds to the fourth quarter of the calendar year.

(3) Data Type. Enter AS10-5 for ambulatory data and emergency department aata. A required entry.

(4) Submission Type. Enter I or R where I indicates an initial submission of a data file or resubmission of a data file prior to certification and R indicates a replacement submission of previously certified patient data where resubmission has been requested or authorized by the Agency. A required entry.

(5) Processing Date. Enter the date that the data file was created in the format YYYY-MM-DD where MM represents numbered months of the year from 1 to 12, DD represents numbered days of the month from 1 to 31, and YYYY represents the year in four digits.

(6) AHCA Facility Number. Enter the identification number of the ambulatory center as assigned by the Agency for reporting purposes. A valid identification number must be between one (1) digit and eight (8) digits. A required entry.

(7) Medicare Number. Enter the Medicare number of the facility as assigned by Centers for Medicare & Medicaid Services (CMS). A valid identification number must contain seven (7) numeric digits. A required entry.

(8) Organization Name. Enter the name of the ambulatory center that performed the ambulatory services represented by the data, and which is responsible for reporting the data. All questions regarding data accuracy and integrity will be referred to this entity. Up to a forty (40) character field.