Common use of Daily File Clause in Contracts

Daily File. The Department will provide to the PH-MCO an 834 Daily Membership File that contains record(s) for each Managed Care Recipient where data for that Recipient (contained in the 834 file layout) has changed that day. The file will contain add, termination and change records, but will contain only 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 24 hours of receipt. The PH-MCO must reconcile this file against its internal membership information and notify the Department within thirty (30) Business Days in order to resolve problems.

Daily File. The Department will provide to the PH-MCO an 834 Daily Membership File that contains record(s) for each Managed Care HealthChoices Recipient where data for that Recipient (contained in the 834 file layout) has changed that day. The file will contain add, termination and change records, but will not contain only one type of managed care coverage—either PH or 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 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 in order to resolve problemsDays.

Daily File. The Department will provide to the PH-MCO an 834 Daily Membership File that contains record(s) for each Managed Care Recipient where data for that Recipient (contained in the 834 file layout) has changed that day. The file will contain add, termination and change records, but will contain only 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 and load this file in its entirety within 24 hours of receipt. The PH-MCO must reconcile all components of this file against its internal membership information and notify the Department within thirty (30) Business Days in order to resolve problems.

Daily File. The Department will provide to the PH-MCO an 834 Daily Membership File that contains record(s) for each Managed Care Recipient where data for that Recipient (contained in the 834 file layout) has changed that day. The file will contain add, termination and change records, but will contain only 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 and load this file in its entirety within 24 hours of receipt. The PH-MCO must reconcile all components of this file against its internal membership information and notify the Department within thirty (30) Business Days in order to resolve problems.