NimbotoolsMedicare Advantage · HEDIS MY 2025

HEDIS PLD Validator

Check your Patient-Level Detail files against the CMS layout before you upload them through Gentran, MFT Internet or Connect:Direct. Catches the Tier 1 and Tier 2 errors that would otherwise come back in a CMS error report two business days later.

Processed locally. Your file never leaves your browser.

What gets checked

File name pattern, test vs. production suffix, and contract number in the name vs. the header. Submission Instructions §4.3, §4.5, §4.8
Header record: tilde, contract H/R + 4 digits, organization name, left-justified 4- or 5-digit Submission ID, blank filler. PLD File 1/2 §3.1
Row length of exactly 482 (File 1) or 245 (File 2) characters. Specs File 1 §1.2 · File 2 §1.2
MBI format, mandatory demographics, no double quotes in name and city fields. Specs §2.3 · Crosswalk §2.1
Logical fields accept only 0 or 1; count fields must be right-justified numbers; member months between 0 and 12. Specs File 1 §2.4–2.5 · Instructions §4.7
12-column decimal weights for HPC and PCR. PLD File 1 cols 224–367 · File 2 cols 113–245
Warnings, not CMS rules: numerator above its denominator, duplicate MBIs in File 1, admission after discharge, discharges outside 2025, non-ASCII bytes.

Based on the HEDIS MY 2025 Patient-Level Detail specifications v2.0 (11/24/2025) published by CMS. This tool does not replace the CMS validation or the NCQA audit; the measure totals still need to match what you entered in IDSS (Specs File 1 §2.1).

Same errors every cycle?

Recurring PLD failures usually trace back to the pipeline that builds the fixed-width file, not to the measures themselves. Nimbotools helps health plan data teams make that step repeatable and testable.

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