Eligibility file definition

Eligibility file means a data set containing demographic information for each individual enrollee eligible for medical benefits for one or more days of coverage at any time during a calendar month for an Oregon resident as defined in ORS 803.355 or a non-Oregon resident who is a member of a PEBB or OEBB group health insurance plan.
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Eligibility file means a census file to determine Members who are eligible to receive Everside Services.
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Eligibility file means the file created by NDPERS and transmitted to PBM listing the names and other pertinent information necessary for PBM to enroll Plan Beneficiaries, terminate enrollment, or to make changes to existing Plan Beneficiary records.
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Examples of Eligibility file in a sentence

  • The State will notify the Contractor of any applicable Patient Liability amounts via the HIPAA standard 820 Premium Payment file, and the retroactive monthly amounts via the HIPPAA standard 834 Eligibility file.

  • The Eligibility file is provided to the Facilitator/RelayHealth by CMS and is updated nightly.

  • The Facilitator/RelayHealth uses the E1 Request to match the data contained within the Request to its Eligibility file.

  • NOTE: RelayHealth will return the information contained in the Eligibility file provided by CMS.

  • Once RelayHealth matches the data to information in the Eligibility file, RelayHealth will return the insurance coverage information to the pharmacy.

  • Pharmacies will submit certain data to RelayHealth so that RelayHealth can attempt to match that data to an Eligibility file provided to RelayHealth by CMS.

  • RelayHealth uses the data in the E1 request to match the data contained within the Request to its Eligibility file.

  • Enrollment data is sent to Contractor pursuant to Attachment D: Enrollment and Eligibility file.

  • For purposes of this Agreement, NH Data means Eligibility file feeds, Claims data feeds, and other data that the Plan Sponsor may direct NH to disclose to Vendor for provision of services above.

  • The Eligibility file is provided to the RelayHealth by CMS and is updated nightly.


More Definitions of Eligibility file

Eligibility file means the list submitted by Plan Sponsor or a third party to Serve You Rx in a reasonably acceptable electronic format indicating persons eligible for coverage under the Benefit Plan, which shall include the information required by Sections 2.2 and 2.3.
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Eligibility file means a data set containing demographic information for each
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Eligibility file means the file provided by Customer (or Customer’s designated affiliate) to Castlight in accordance with Castlight’s specifications that identifies all Members.
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Eligibility file means electronic communication supplied to PBM or its Vendor by Client (or its designee) which identifies the Members covered under the Plan Document, along with other eligibility information required by PBM for PBM to provide Services.
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Eligibility file means a data set containing demographic information for each individual enrollee eligible for medical benefits for one or more days of coverage at any time during a calendar month for an Oregon resident as defined in ORS 803.355 or a
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Related to Eligibility file

  • Eligibility means the decision as to whether an individual qualifies, under financial and nonfinancial requirements, to receive program benefits.

  • Eligibility Waiting Period means the continuous length of time you must be in Active Employment in an eligible class to reach your Eligibility Date.

  • Eligibility and selection criteria means criteria for determining:

  • Eligibility Requirement means all eligibility requirements and other qualification requirements for a person to act in the applicable Corporate Trust Capacity under any Appointment as set forth in the related Corporate Trust Contract, including any required authorizations or licenses from the Federal National Mortgage Association, the Federal Home Loan Mortgage Corporation, the Government National Mortgage Association, the Federal Housing Administration, the Federal Home Loan Bank or the Department of Veterans Affairs.

  • eligibility adviser means: (i) a person that is registered as an investment dealer and authorized to give advice with respect to the type of security being distributed; and (ii) in Saskatchewan or Manitoba, also means a lawyer who is a practicing member in good standing with a law society of a jurisdiction of Canada or a public accountant who is a member in good standing of an institute or association of chartered accountants, certified general accountants or certified management accountants in a jurisdiction of Canada provided that the lawyer or public accountant must not: (A) have a professional, business or personal relationship with the issuer, or any of its directors, executive officers, founders, or control persons, and (B) have acted for or been retained personally or otherwise as an employee, executive officer, director, associate or partner of a person that has acted for or been retained by the issuer or any of its directors, executive officers, founders or control persons within the previous 12 months;