Common use of Monthly File Clause in Contracts

Monthly File. The Department will provide an 834 Monthly Membership File for each MCO on the next to the last Saturday of each month. The file contains the MA Eligibility Period, PH-MCO coverage, BH-MCO coverage and other Recipient demographic information. It will contain only one record for each Managed Care Recipient (the most current) where the Member is both MA and Managed Care eligible at some point in the following month. The PH-MCO may reconcile this membership file against its internal membership information and notify the Department of any discrepancies found within the data on the file within thirty (30) Business Days, in order to resolve problems. Recipients not included on this file with an indication of prospective coverage will not be the responsibility of the PH- MCO unless a subsequent 834 Daily Membership File indicates otherwise. Those with an indication of future month coverage will not be the responsibility of the PH-MCO if an 834 Daily Membership File received by the PH-MCO prior to the beginning of the future month indicates otherwise.

Monthly File. The Department will provide an 834 Monthly Membership File for each PH-MCO on the next to the last Saturday of each month. The file contains the MA Eligibility Period, PH-PH- MCO coverage, BH-MCO coverage and other Recipient demographic information. It will contain only one record for each Managed Care HealthChoices Recipient (the most current) where the Member is both MA and Managed Care eligible at some point in the following month. The PH-MCO may must reconcile this membership file against its internal membership information and notify the Department of any discrepancies found within the data on the file within thirty (30) Business Days, in order to resolve problems. Recipients not included on this file with an indication of prospective coverage will not be the responsibility of the PH- MCO unless a subsequent 834 Daily Membership File indicates otherwise. Those with an indication of future month coverage will not be the responsibility of the PH-MCO if an 834 Daily Membership File received by the PH-MCO prior to the beginning of the future month indicates otherwise.

Monthly File. The Department will provide an 834 Monthly Membership File for each PH-MCO on the next to the last Saturday of each month. The file contains the MA Eligibility Period, PH-MCO coverage, BH-MCO coverage and other Recipient demographic information. It will contain only one record for each Managed Care HealthChoices Recipient (the most current) where the Member is both MA and Managed Care eligible at some point in the following month. The PH-MCO may must reconcile this membership file against its internal membership information and notify the Department of any discrepancies found within the data on the file within thirty (30) Business Days, in order to resolve problems. Recipients not included on this file with an indication of prospective coverage will not be the responsibility of the PH- PH­ MCO unless a subsequent 834 Daily Membership File indicates otherwise. Those with an indication of future month coverage will not be the responsibility of the PH-MCO if an 834 Daily Membership File received by the PH-MCO prior to the beginning of the future month indicates otherwise.

Monthly File. The Department will provide an 834 Monthly Membership File for each PH-MCO on the next to the last Saturday of each month. The file contains the MA Eligibility Period, PH-MCO coverage, BH-MCO coverage and other Recipient demographic information. It will contain only one record for each Managed Care HealthChoices Recipient (the most current) where the Member is both MA and Managed Care eligible at some point in the following month. The PH-MCO may must reconcile this membership file against its internal membership information and notify the Department of any discrepancies found within the data on the file within thirty (30) Business Days, in order to resolve problems. Recipients not included on this file with an indication of prospective coverage will not be the responsibility of the PH- MCO unless a subsequent 834 Daily Membership File indicates otherwise. Those with an indication of future month coverage will not be the responsibility of the PH-MCO if an 834 Daily Membership File received by the PH-MCO prior to the beginning of the future month indicates otherwise.