Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
Code Type Title Short Definition Definition
098 R Medicaid
Previously
Turned Off
MCAID PREV
OFF
A correction transaction (Transaction Type 01) was rejected because this transaction attempted to
set the Medicaid status for the beneficiary to OFF. The Medicaid status for the beneficiary was
already OFF for the month in question.
Note: This TRC is only applicable for submitted correction transactions (Transaction Type 01) with
effective dates prior to 1/1/2008.
099 M Medicaid
Period
Change/Canc
ellation
100 A PBP Change
Accepted as
Submitted
102 R Rejected;
Incorrect or
Missing
Application
Date
MCAID CHANGE
PBP CHANGE OK
BAD APP DATE
Plan Action: None required. Verify the Plan records.
A change has been made to a period of Medicaid status information for the beneficiary.
Plan Action: Plan should update beneficiary record.
A submitted PBP Change transaction (Transaction Type 61) has been successfully processed. The
beneficiary has been moved from the original PBP to the new PBP. The effective date of
enrollment in the new PBP is reported in fields 18 and 24 of the TRR data record. The effective
date will always be the first day of the month.
This is the definitive PBP Change acceptance record. Other accompanying replies with different
TRCs may give additional information about this accepted PBP Change.
Field 20 (Plan Benefit Package ID) contains the new PBP identifier. The old PBP is reported in
field 29 (Prior Plan Benefit Package ID).
Plan Action: Ensure the Plan’s system matches the information included in the TRR record. Take
the appropriate actions as per CMS enrollment guidance.
If the Application Date on an enrollment transaction (Transaction Type 61) is blank or contains a
valid date that is not appropriate for the submitted transaction, TRC 102 is returned in the TRR
record. Examples of inappropriate application dates:
Date is blank
Date is later than the submitted Effective Date.
Date does not lie within the election period specified on the submitted transaction
Note: Plans should see Chapter 2 of the MMCM or the PDP Guidance on Eligibility, Enrollment
and Disenrollment for detailed descriptions of the Election Periods.
Plan Action: Correct the Application Date and resubmit if appropriate.
December 28, 2012 I-23 Transaction Reply Codes (TRCs)