07172023 Enc Connect Direct Form

Encounter Data
Connect:Direct Form

OMB No. 0938-1152
Expires 03/31/2025

Contact Information
Contact the Customer Service Support Center (CSSC) Help Desk with any questions using the following
contact information:
Phone Number: 1-877-534-2772
Email Address: [email protected]

Network Mapping Values
In order to set up network mapping entry by the submitter, the following values are provided. Palmetto
GBA uses Secure Point of Entry (SPOE) to enforce data security. The CSSC Help Desk will provide the
Network Address Translation (NAT) IP Address and Listener Port to the submitter during the
connectivity testing phase.
Node ID

SCA.A70NDM.MC

System Platform

OS390, z/OS

Data Submission Information
Listed below are values needed by the submitter in order to code Connect:Direct scripts. The CSSC
Help Desk will provide the Submitter ID value that will be used in the Data Set Name (DSN).
DSN

MAB.PROD.NDM.PROD.EDST.(+1)

DSN TEST

MAB.PROD.NDM.TEST.EDST.(+1)

DISP

(NEW,CATLG,DELETE)

UNIT

SYSDG

SPACE

(CYL,(100,100),RLSE)

DCB

(RECFM=FB,LRECL=80,BLKSIZE=27920)

Form CMS-10340 (03/2025)

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Submitter’s Network Mapping Values
Provide the following network mapping values to establish bi-directional data transfers with Palmetto
GBA.
NAT IP Address
(Obtain from the Network Service Vendor)
Listener Port
Node ID
Mainframe
System Platform

AS/400
Server

Additional Information
If submitting data files, the Production ID is required. If the submitter’s system requires login credentials
to receive data files, provide the Login ID.
Production ID
Login ID
Technical Contact Name
Phone Number
E-mail Address

Dataset Names
To receive multiple data files and prevent overwriting of existing files, it is recommended that
Generational Data Group (GDG) dataset names (mainframe platform only) or dataset names containing
date and timestamp (any platform) are provided.

Frequency = Daily
Invalid Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
TA1 Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name

Form CMS-10340 (03/2025)

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999A Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
999R Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
277CA Acknowledgement Response
Format

DSORG=PS,LRECL=80,RECFM=FB

Dataset Name
MAO-001 Data Duplicates Report
Format

DSORG=PS,LRECL=287,RECFM=FB

Dataset Name
MAO-001 Data Duplicates File
Format

DSORG=PS,LRECL=287,RECFM=FB

Dataset Name
MAO-002 Data Processing Status Report
Format

DSORG=PS,LRECL=154,RECFM=FB

Dataset Name
MAO-002 Data Processing Status File
Format

DSORG=PS,LRECL=154,RECFM=FB

Dataset Name
Medicare Advantage Dental Validation Report
Format

DSORG=PS,LRECL=133,RECFM=FB

Dataset Name

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays
a valid OMB control number. The valid OMB control number for this information collection is 0938-1152. The time required to
complete this information collection is estimated to average 10 minutes per response, including the time to review instructions, search
existing data resources, gather the data needed, and complete and review the information collection. If you have any comments
concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: CMS, 7500 Security Boulevard,
Attn: PRA Reports Clearance Officer, Baltimore, Maryland 21244-1850.
Form CMS-10340 (03/2025)

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