Non-MSP Processing. VDSA partners can use the new non-MSP record layout for three purposes. They are identified on the input record by action type: • Drug Coverage Reporting (D) – To allow reporting of other drug coverage to MBD for TrOOP to utilize. • Non-Reporting (N) – To determine entitlement to Medicare. An Action Type of D or N will always be required to determine the purpose of the submission. For Non-Reporting records the following fields are required in addition to action type: • Medicare ID (HICN or MBI) or SSN • Surname • First initial • Date of birth • Sex (DCN and middle initial can be populated if available.) When a non-MSP ‘D’ record is received with a coverage type that indicates there is prescription drug coverage (U, V, W, X, Y, Z, 4, 5, 6), the BCRC will attempt to create an RX transaction. The record will go through the beneficiary matching process first to establish that beneficiary data is valid. Records that aren’t matched with an active beneficiary will be rejected by the BCRC system. The drug record will be compared to the BCRC’s existing drug coverage table for matches for Medicare ID, effective date, patient relationship, coverage type, and VDSA ID. If these fields all match the record will the considered an update. Otherwise the record will be added to the data table and forwarded to MBD.
Appears in 7 contracts
Samples: Sharing Agreement, Sharing Agreement, Sharing Agreement
