Enrollment and Capitation Reconciliation. i. The MCP shall maintain the integrity of its membership data through reconciliation of the daily HIPAA 834C (Daily Benefit Enrollment and Maintenance File) and the monthly HIPAA 834F (Monthly Benefit Enrollment and Maintenance File) transactions. The monthly cycle is based on state cut-off dates (e.g., June 2012 enrollment reflects changes from that occurred April 19, 2012 – May 21, 2012). Please reference the Processing Dates for Calendar Year memo issued annually. Discrepancies between the HIPAA 834C and 834F that have a negative impact on a member’s access to care must be reported to ODM within one (1) business day.
Appears in 8 contracts
Samples: Provider Agreement, Provider Agreement, Provider Agreement
Enrollment and Capitation Reconciliation. i. The MCP shall maintain the integrity of its membership data through reconciliation of the daily HIPAA 834C (Daily Benefit Enrollment and Maintenance File) and the monthly HIPAA 834F (Monthly Benefit Enrollment and Maintenance File) transactions. The monthly cycle is based on state cut-off dates (e.g., June 2012 enrollment reflects changes from that occurred April 19, 2012 – May 21, 2012). Please reference the Processing Dates for Calendar Year memo issued annually. Discrepancies between the HIPAA 834C and 834F that have a negative impact on a member’s access to care must be reported to ODM within one (1) business day.
Appears in 1 contract
Samples: Provider Agreement
