Common use of Downloaded Enrollment/Disenrollment Reports Clause in Contracts

Downloaded Enrollment/Disenrollment Reports. a. The Agency or its Agent will report Enrollment/Disenrollment information to the Health Plan. b. The Health Plan shall review the Enrollment/Disenrollment reports for accuracy and will notify the Agency within three (3) Business Days of any discrepancies. Failure to notify the Agency of any discrepancies within three (3) Business Days shall lead to fines and other sanctions as detailed in Section XIV, Sanctions. c. The Enrollment/Disenrollment Reports will use HIPAA-compliant standard transactions. The Agency or its Agent will use the X12N 834 transaction for all Enrollee maintenance and reporting. The Health Plan must be capable of receiving and processing X12N 834 transactions. d. During the transition period from proprietary to standard formats, the Health Plan shall cooperatively participate with the Agency in the transition process.