Member Database File Specification

Introduction

This page provides details of the member database (MDB) file specification to be used when submitting member data to Healthcode.

File Naming

The following filename convention should be used:

MDBYYDDD.csv

Where:

MDB: Identifies the file type as Member Database
YY: The year of submission
DDD: The Julian Day of the year

File Format

Membership data will be transferred in CSV format conforming to the following rules:

  • The file will be encoded using UTF-8
  • Columns will be separated with , (x2C)
  • String values will be delimited with " (x22)
  • Date and Date/Time values will be in ISO 8601 format
  • Each row will be terminated with Carriage Return & Linefeed (x0D + x0A) characters
  • The first row will contain column headers. The column headers you use in your CSV must match exactly the ‘Column Header’ value below. (Case Sensitive).
  • Optional fields that have no value specified should be omitted.  (The column header must be included.  A comma separator must be included for any omitted fields).

Each data row will contain the following columns:

Column HeaderMandatoryTypeMax. Size/FormatDescription
MembershipIDYesString50Insurers unique identifier for this member
GroupPolicyIDNoString50Identifier for this member’s policy, where the member is part of a group policy
FamilyNameYesString50Members family name
GivenNameYesString50Members given or first name
OtherInitialsNoString50Members other initials or names
BirthSex1YesString1Members sex at birth:
M – Male,
F – Female,
O – Other,
U – Unknown
DateofBirthYesDateYYYY-MM-DDMembers date of birth
AddressLine1YesString50Members Address
AddressLine2YesString50
AddressLine3NoString50
AddressLine4NoString50
PostcodeYesString10Members Postcode
CountryNoString22 Alpha Country Code, conforming to ISO-3166
CoverStartDateYesDateYYYY-MM-DDThe date on which cover for this member started
CoverEndDateYesDateYYYY-MM-DDThe date on which cover for this member ends
LapsedIndicatorNoString1Indicates that cover has lapsed (Y or N)
LapsedDateNoDateYYYY-MM-DDThe date on which cover lapsed
PolicySchemeNoString50Policy scheme to which this group/member belongs
DoNotRejectNoString1An indicator (Y/N) specifying that bills for this member should never be rejected based on information in this record.
GenderIdentity2NoString1The gender by which the member prefers to be identified:

1 – Male (including trans man)
2 – Female (including trans woman)
3 – Non-binary
4 – Other
Z – Not Stated
CurrencyNoString1ISO-4217 3 character currency code of the monetary values in this record
BenefitLimitNoDecimalNNNNNNNN.NNThe maximum benefit available to the member on this policy
BenefitConsumedNoDecimalNNNNNNNN.NNThe amount of benefit already used by this member on this policy
BenefitConsumedAsOfNoDate/TimeYYYY-MM-DDTHH:MM:SSThe date/time on which the consumed benefit amount was calculated.
ExcessNoDecimalNNNNNNNN.NNThe total amount of excess to be paid by the member on this policy
ExcessApplicableToNoString1The period over which the excess amount is applicable
P – Policy Period
C – Each Claim/Episode
ExcessPaidNoDecimalNNNNNNNN.NNThe amount of excess already paid by the member on this policy.
ExcessPaidAsOfNoDate/TimeYYYY-MM-DDTHH:MM:SSThe date/time on which the paid excess was calculated.
CoPaymentNoDecimalNNNNNNNN.NNThe amount to be paid by the member under any policy co-payment arrangement.

Assumed to be ‘Per Claim’
CoPaymentTypeNoString1M – Monetary Value
P – Percentage
  1. BirthSex is aligned with the NHS Data Model item PERSON STATED GENDER CODE ↩︎
  2. GenderIdentity is aligned with the NHS Data Model item GENDER IDENTITY CODE ↩︎

Sample MDB File