Common use of Monthly File Clause in Contracts

Monthly File. The Department will provide an 834 Monthly Eligibility File to 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 the most current record for each HealthChoices Recipient where the Member is both MA and Managed Care eligible at some point in the following month. The PH-MCO must reconcile this membership file against its internal membership data and notify the Department of any discrepancies within thirty (30) Business Days. 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 Eligibility File indicates otherwise. Those with an indication of future month coverage will not be the responsibility of the PH-MCO if an 834 Daily Eligibility 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 Eligibility Membership File to 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 the most current one record for each 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 must reconcile this membership file against its internal membership data information and notify the Department of any discrepancies found within the data on the file within thirty (30) Business Days. 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 Eligibility 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 Eligibility 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 Eligibility Membership File to 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 the most current one record for each 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 must reconcile this membership file against its internal membership data information and notify the Department of any discrepancies found within the data on the file within thirty (30) Business Days. 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 Eligibility 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 Eligibility 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 Eligibility Membership File to 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 the most current one record for each 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 must reconcile this membership file against its internal membership data information and notify the Department of any discrepancies found within the data on the file within thirty (30) Business Days. 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 Eligibility 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 Eligibility Membership File received by the PH-MCO prior to the beginning of the future month indicates otherwise.