Inputs. The Recipient Data Maintenance function will accept input from various sources to add, change, or close records on the file(s). Inputs to the Recipient Data Maintenance function include: 1. Daily and monthly electronic member eligibility updates (HIPAA ASC X12 834) 2. Claim/encounter history – sequential file; file description to be determined 3. Social demographic information 4. Initial Implementation of the Contract, the following inputs shall be provide to the contractor: Initial Member assignment file (sequential file; format to be supplemented at contract execution); a file will be sent approximately sixty (60) calendar days prior to the Contractor effective date of operations Member claim history file – twelve (12) months of member claim history (sequential file; format to be supplemented at Contract execution) Member Prior Authorizations in force file (medical and pharmacy; sequential file; format will be supplemented at Contract execution)
Appears in 4 contracts
Samples: Medicaid Managed Care Contract, Medicaid Managed Care Contract, Medicaid Managed Care Contract
