Daily File. The Department will provide a Daily 834 Eligibility File to the PH-MCO that contains one record for each action taken in CIS/eCIS for each HealthChoices Recipient where data for that Recipient has changed that day. The file will contain add, termination and change records, but will not contain BH- related information. The file contains demographic changes, eligibility changes, Enrollment changes, Members enrolled through the automatic assignment process, and TPL information. The PH-MCO must process this file within twenty-four (24) hours of receipt. The PH-MCO must reconcile this file against its internal membership information and notify the Department of any discrepancies within thirty (30) Business Days.
Daily File. The Department will provide to the PH-MCO an 834 Daily Membership File that contains record(s) for each Managed Care Recipient where data for that Recipient (contained in the 834 file layout) has changed that day. The file will contain add, termination and change records, but will contain only one type of managed care coverage—either PH or BH. The file contains demographic changes, eligibility changes, Enrollment changes, Members enrolled through the automatic assignment process, and TPL information. The PH-MCO must process this file within 24 hours of receipt. The PH-MCO must reconcile this file against its internal membership information and notify the Department within thirty (30) Business Days in order to resolve problems.
Daily File. The Department will provide to the CHC-MCO a Daily Participant Enrollment File that contains record(s) for each Participant where data for that Participant has changed that day. The file will contain add, termination, and change records, but will contain only one type of managed care coverage, either PH or BH. The file contains demographic changes, eligibility changes, Enrollment changes, Participants enrolled through the automatic assignment process, and TPL information. The CHC-MCO must process this file within twenty-four (24) hours of receipt. The CHC-MCO must reconcile this file against its internal Participant information and notify the Department of any discrepancies within thirty (30) business days.
Daily File. This will contain the Eligibility of Public Benefits section of the WIC Signature Page for all applicants, parents, guardians or other authorized representatives 18 years of age and older who come for a Certification appointment.
Daily File. The Department will provide a Daily 834 Eligibility File to the CHC-MCO that contains one record for each action taken in eCIS for each Participant where data for that Participant has changed that day. The file will contain add, termination, and change records, but will not contain BH-related information. The file will contain demographic changes, eligibility changes, Enrollment changes, Participants enrolled through the automatic assignment process, and TPL information. The CHC-MCO must process this file within twenty-four (24) hours of receipt. The CHC-MCO must reconcile this file against its internal Participant data and notify the Department of any discrepancies within thirty (30) business days.
Daily File. The Department will provide to the Contractor by electronic file transmission, a daily file that lists demographic changes, eligibility changes, enrollment changes and Members enrolled through the automatic assignment process. The Contractor must reconcile this file against its internal membership information and notify the Department within thirty (30) business days in order to resolve problems.
Daily File. The Department will provide to the PCO an 834 Daily Membership File that contains records for each PCO Member where data for that Member (contained in the 834 file layout) has changed that day. The file contains add, termination and change records, and demographic changes, eligibility changes, Enrollment changes, Members enrolled through the automatic assignment process, and TPL information. The PCO must process this file within 24 hours of receipt. The PCO must reconcile this file against its internal membership information and notify the Department of any discrepancies within thirty
Daily File. The Department will provide to the CHC-MCO an Daily Participant File that contains record(s) for each Community HealthChoices Participant where data for that Participant has changed that day. The file will contain add, termination and change records, but will contain only one type of managed care coverage—either CHC, PH or BH. The file contains demographic changes, eligibility changes, Enrollment changes, Participants enrolled through the automatic assignment process, and TPL information. The CHC-MCO must process this file within 24 hours of receipt. The CHC-MCO must reconcile this file against its internal Participant information and notify the Department of any discrepancies within thirty (30) business days.
Daily File. The Department will provide the PH-MCO with an 834 Daily Eligibility File that contains one record for each HealthChoices Recipient where data for that Recipient has changed that day. The file contains add, termination and change records, but does not contain BH-related information. The file contains demographic changes, eligibility changes, Enrollment changes, Members enrolled through the automatic assignment process, and TPL information. The PH-MCO must process this file within 24 hours of receipt. The PH-MCO must reconcile this file against its internal membership information and notify the Department of any discrepancies within thirty (30) Business Days.
