Daily File. The Department will provide a Daily 834 Eligibility File to the PH-MCO that contains one record for each action taken in CIS/eCIS for each HealthChoices Recipient where data for that Recipient has changed that day. The file will contain add, termination and change records, but will not contain BH- related information. The file contains demographic changes, eligibility changes, Enrollment changes, Members enrolled through the automatic assignment process, and TPL information. The PH-MCO must process this file within twenty-four (24) hours of receipt. The PH-MCO must reconcile this file against its internal membership information and notify the Department of any discrepancies within thirty (30) Business Days.
Appears in 4 contracts
Samples: Healthchoices Agreement, Grant Agreement, Healthchoices Agreement
Daily File. The Department will provide a Daily 834 Eligibility File to the PH-MCO that contains one record for each action taken in CIS/eCIS for each HealthChoices Recipient where data for that Recipient has changed that day. The file will contain add, termination and change records, but will not contain BH- related information. The file contains will also contain demographic changes, eligibility changes, Enrollment changes, Members enrolled through the automatic assignment process, and TPL information. The PH-MCO must process this file within twenty-four (24) hours of receipt. The PH-MCO must reconcile this file against its internal membership information and notify the Department of any discrepancies within thirty (30) Business Days.
Appears in 4 contracts
Samples: Healthchoices Agreement, Healthchoices Agreement, Healthchoices Agreement
Daily File. The Department will provide a Daily 834 Eligibility File to the PH-MCO an 834 Daily Membership File that contains one record for each action taken in CIS/eCIS record(s) for each HealthChoices Recipient where data for that Recipient has changed that day. The file will contain add, termination and change records, but will not contain BH- related informationonly one type of managed care coverage—either PH or BH. The file contains demographic changes, eligibility changes, Enrollment changes, Members enrolled through the automatic assignment process, and TPL information. The PH-MCO must process this file within twenty-four (24) 24 hours of receipt. The PH-MCO must reconcile this file against its internal membership information and notify the Department of any discrepancies discrepencies within thirty (30) Business Days.
Appears in 3 contracts
Samples: Healthchoices Agreement, Healthchoices Agreement, Healthchoices Agreement
