Record Layout and File Submissions Sample Clauses

Record Layout and File Submissions. ‌ A1: The “Document Control Number” (DCN) is an ID number assigned by the VDSA partner, for its own use as a tracking code. While other information in an input record may have changed in the response record, the DCN will not. Consequently, using the DCN will always allow a VDSA partner to match and link an input record with its corresponding response record. Supplying a DCN on an input record is mandatory. On the Non-MSP Input File record layout the DCN field is Number 19. A2: For VDSA reporting the Medicare ID is the “gold standard.” A correct Medicare ID will always identify a Medicare beneficiary. More generally, to confirm a beneficiary data match we always need either the Medicare ID or the SSN. Having one of these numbers is necessary to determine if a Covered Individual you submit is also entitled to Medicare. We encourage you to send us both numbers in case one or the other contains an error. Note: If you provide a Medicare ID (HICN or MBI), or an SSN, on either Medicare Secondary Payer (MSP) or non- MSP input files, we will return the most current Medicare ID in the response files. A3: No. Without either the Medicare ID or SSN, do not submit a record for that individual. The Medicare ID or SSN are the primary identifiers we use to confirm Medicare entitlement. Without one or both of those numbers, a record will not process. A4: See if you have a Medicare ID (HICN or MBI) for that individual. If you do not, don’t send the record. A5: Almost. Using an SSN to confirm that the individual on a submitted record is a Medicare beneficiary requires the SSN, the first 6 characters of the person's surname, first name initial, date of birth, and gender. A6: You should include as much of the personal identifying information as possible. It is often possible to find Medicare entitlement even if not all of the personal identifying information exists or is correct on the record you submit. We use a matching algorithm that accepts a match when at least 3 of the 4 personal identifying pieces of information for the submitted SSN or Medicare ID (HICN or MBI) are correct. A7: The collection and use of individual SSNs is now limited by an evolving body of federal and state law and regulation. When an SSN is to be used as personal health information, management of the SSN (who can collect it; for what reason; with what other entity or person can it be shared) is directed by regulations required by the Federal Health Insurance Portability and Accountability Act (HIPAA). ...
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Record Layout and File Submissions. How will you use the TINs you are collecting? A1: Use of TINs provides for a more efficient method of coordinating benefits on the “front end.” Not having TINs increases recovery costs to both CMS and the Treasury on the “back end”, and can lead to an inefficient recovery process that adds administrative burden to the debtor. CMS routinely uses TIN numbers to aggregate demands for recovery of mistaken Medicare payments; without the TINs, administrative costs go up.
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Record Layout and File Submissions. Q1: Why does CMS insist we fill the “DCN” field on Input Files? Q2: Throughout the record layouts there is a field for Medicare ID (HICN or MBI). Some of the data field descriptions state that the Medicare ID is not required if the SSN is provided. This is not explicitly stated in others. Please confirm that an SSN is an acceptable substitute for the Medicare ID in all the layouts. Q3: We don't have all of the SSNs for all of our covered individuals. Should we include a record with no SSN or Medicare ID (HICN or MBI) on the file anyway? Q4: What should we do for records that do not have the SSN? Q5: Is just the SSN enough to make a match in your database? Q6: What if we have the SSN but not all of the personal identifying information (first 6 characters of the person's surname, first name initial, date of birth, and sex code) that you need to confirm Medicare entitlement? Q7: Many of our enrollees are concerned about identity theft and are wary about giving us their Social Security Numbers (SSNs). How can we assure them that an individual’s SSN will be protected and used appropriately?
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