ROSTER RECONCILIATION Sample Clauses
The Roster Reconciliation clause establishes the process for verifying and aligning the list of individuals or entities involved in a particular agreement or project. Typically, this involves both parties reviewing and confirming the accuracy of the roster at specified intervals, such as monthly or quarterly, and making any necessary updates to reflect changes like new hires or departures. By formalizing this process, the clause ensures that all parties have a clear, up-to-date understanding of who is covered or involved, thereby reducing disputes and administrative errors related to personnel or participant lists.
ROSTER RECONCILIATION. All enrollments are effective the first of the month. SDOH Responsibilities:
1) The SDOH maintains both the PCP subsystem enrollment files and the WMS eligibility files, using data input by the LDSS. SDOH uses data contained in both these files to generate the Roster. APPENDIX H October 1, 2004 H-7
2) SDOH shall send each MCO and LDSS monthly (according to a schedule established by SDOH), a complete list of all Enrollees for which the Contractor is expected to assume medical risk beginning on the 1st of the following month (First Monthly Roster). Notification to MCOs and LDSS will be accomplished via paper transmission, magnetic media, or the HPN.
3) SDOH shall send each MCO and LDSS monthly, at the time of the first monthly roster production, a Disenrollment Report listing those Enrollees from the previous month's roster who were disenrolled, transferred to another MCO, or whose enrollments were deleted from the file. Notification to the MCOs and LDSSs will be accomplished via paper transmission, magnetic media, or the HPN.
4) The SDOH shall also forward an error report as necessary to each MCO and LDSS.
5) On the first (1st) weekend after the first (1st) day of the month following the generation of the first (1st) Roster, SDOH shall send MCOs and LDSS a second Roster which contains any additional Enrollees that the LDSS has added for enrollment for the current month. The SDOH will also include any additions to the error report that have occurred since the initial error report was generated. LDSS RESPONSIBILITIES:
1) LDSS must notify the Contractor electronically or in writing of changes in the First Roster and error report, no later than the end of the month. (Note: To the extent practicable the date specified must allow for timely notice to Enrollees regarding their enrollment status. MCOs and the LDSS may develop protocols for the purpose of resolving Roster discrepancies that remain unresolved beyond the end of the month. These protocols should be contained in Section G of this Appendix.)
2) Enrollment and eligibility issues are reconciled by the LDSS to the extent possible, through manual adjustments to the PCP subsystem enrollment and WMS eligibility files, if appropriate. MCO RESPONSIBILITIES:
ROSTER RECONCILIATION a) All Enrollments are effective the first of the month.
ROSTER RECONCILIATION a) All Enrollments are effective the first of the month.
b) SDOH Responsibilities:
i) The SDOH maintains both the PCP subsystem Enrollment files and the WMS eligibility files, using data entered by the LDSS. SDOH uses data contained in both these files to generate the Roster.