Medicare Advantage and Prescription Drug Plans December 28 ...

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Plan Communications User Guide Appendices, Version 6.3 F.28 Monthly Medicare Second Payer (MSP) Information Data File The Monthly MSP Information data file is sent directly to Plans on the first Monday after the MARx month-end processing completes. This file contains a subset of information to assist Plans with reconciling payment; the full monthly MSP COB file distributed at the beginning of each month contains more detail. F.28.1 Header Record FIELD NAME SIZE POSITION TYPE COMMENTS Header Code 8 1-8 CHAR File/record identification purposes only, 'CMSMSPIH'. Sending Entity 3 9-11 CHAR Hard Coded as 'MBD' File Creation Date 8 12-19 ZD CCYYMMDD – Format Filler 481 20-500 CHAR All spaces Total Length = 500 F.28.2 Detail Record FIELD NAME SIZE POSITION TYPE COMMENTS RRB-HIC-NUM 12 1-12 CHAR Use RRB_HIC_NUM if available; else, use first 9 bytes mapped to BENE_CAN_NUM; next 2 bytes mapped to BIC_CD ; 12th byte is a space Date of Birth 8 13-20 CHAR CCYYMMDD FORMAT Gender Code 1 21 CHAR Direct Mapping: 0 = Unknown, 1 = Male, 2 = Female Contract Number 5 22-26 CHAR Direct Mapping PBP Number 3 27-29 CHAR Direct Mapping MSP Coverage Effective Date 8 30-37 INT CCYYMMDD FORMAT MSP Coverage Termination Date 8 38-45 INT CCYYMMDD FORMAT Primary Insurance Code COB Contractor Number 1 46 CHAR Convert as follows: 12…A (Working Aged) 13…B (ESRD) 43…G (Disabled) 5 47-51 CHAR Direct Mapping Insurer Name 32 52-83 CHAR Direct Mapping Insurer Address Line 1 32 84-115 CHAR Direct Mapping Insurer Address Line 2 32 116-147 CHAR Direct Mapping Insurer City name 15 148-162 CHAR Direct Mapping Insurer State Code 2 163-164 CHAR Direct Mapping Insurer Zip Code 9 165-173 CHAR Direct Mapping Policy Number 17 174-190 CHAR Direct Mapping Filler 310 191-500 CHAR Hard Coded as Spaces Total Length = 500 December 28, 2012 F-142 MSP Information Data File
F.28.3 Trailer Record Plan Communications User Guide Appendices, Version 6.3 FIELD NAME SIZE POSITION SIZE COMMENTS Trailer Code 8 1-8 CHAR File/record identification purposes only, 'CMSMSPIT'. Sending Entity 3 9-11 CHAR Hard Coded as 'MBD' File Creation Date 8 12-19 ZD CCYYMMDD – Format Detail Record Count 9 20-28 ZD Number of detail records, excluding header and trailer Filler 472 29-500 CHAR All spaces Total Length = 50 December 28, 2012 F-143 MSP Information Data File
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Medicare Advantage and Prescription
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Plan Communications User Guide Appe
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F.10.3 Trailer Record Plan Communic
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I.3 Obsolete Transaction Reply Code
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CMS Transmittals to the Plans Plan
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ID# Transmittal Monthly Transmittal
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Medicare Advantage and Prescription Drug Plans December 28 ...

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