Medicare Advantage and Prescription Drug Plans December 28 ...

More documents

Recommendations

Info

Plan Communications User Guide Appendices, Version 6.3 Code Type Title Short Definition Definition 117 A FBD Auto Enrollment Accepted 118 A LIS Facilitated Enrollment Accepted 119 A Premium Amount Change Accepted FBD AUTO ENROLL LIS FAC ENROLL PREM AMT CHG This new enrollment transaction (Transaction Type 61) was the result of a Plan-submitted or CMSinitiated auto-enrollment of a full-benefit dual-eligible beneficiary into a Part D Plan. The enrollment was accepted. The effective date of the new enrollment is shown in the Effective Date (field 18) of the TRR data record. Other accompanying replies with different TRCs may give additional information about this new enrollment. Plan Action: Ensure the Plan’s system matches the information included in the TRR record. Take the appropriate actions as per CMS enrollment guidance. This new enrollment transaction (Transaction Type 61) was the result of a Plan-submitted or CMSinitiated facilitated enrollment of a low income beneficiary into a Part D Plan. The effective date of the new enrollment is shown in the Effective Date (field 18) of the TRR data record. Other accompanying replies with different TRCs may give additional information about this new enrollment. Plan Action: Ensure the Plan’s system matches the information included in the TRR record. Take the appropriate actions as per CMS enrollment guidance. A Part C Premium Change transaction (Transaction Type 78) was accepted. The Part C premium amount has been updated with the amount submitted on the transaction. The amount may have also been updated by CMS. The effective date of the new premium will be reported in TRR data record field 18. The amount of the new Part C premium will be reported in field 19 of the TRR record. Plan Action: Update the Plan’s records accordingly, ensuring that the beneficiary’s premium amounts are implemented as of the effective date in field 18. Take the appropriate actions as per CMS enrollment guidance. December 28, 2012 I-29 Transaction Reply Codes (TRCs)
Plan Communications User Guide Appendices, Version 6.3 Code Type Title Short Definition Definition 120 A PPO Change Sent to W/H Agency WHOLD UPDATE As a result of an accepted Plan-submitted transaction (Transaction Types 51, 61, 73, 74, 75) or UI update to a beneficiary’s records, information has been forwarded to SSA/RRB to update SSA/RRB records and implement any requested premium withholding changes. Any requested change will not take effect until an SSA/RRB acceptance is received. Plans are notified of the SSA/RRB acceptance with a TRC 185 in a future TRR data file. Plan Action: None required. Take the appropriate actions as per CMS enrollment guidance. Note: The Plan will not see the result of any PPO change until they have received a TRC 185 on a future TRR. December 28, 2012 I-30 Transaction Reply Codes (TRCs)
Page 1 and 2:
Medicare Advantage and Prescription
Page 3 and 4:
Plan Communications User Guide Appe
Page 5 and 6:
Page 7 and 8:
Page 9 and 10:
Page 11 and 12:
Page 13 and 14:
Page 15 and 16:
Page 17 and 18:
Page 19 and 20:
Page 21 and 22:
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45 and 46:
Page 47 and 48:
Page 49 and 50:
Page 51 and 52:
Page 53 and 54:
Page 55 and 56:
Page 57 and 58:
Page 59 and 60:
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Page 67 and 68:
Page 69 and 70:
Page 71 and 72:
Page 73 and 74:
Page 75 and 76:
Page 77 and 78:
F.10.3 Trailer Record Plan Communic
Page 79 and 80:
F.11.2 Record Type 2 Plan Communica
Page 81 and 82:
Page 83 and 84:
Page 85 and 86:
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
Page 97 and 98:
Page 99 and 100:
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Page 107 and 108:
Page 109 and 110:
Page 111 and 112:
Page 113 and 114:
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
Page 121 and 122:
Page 123 and 124:
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
F.21.2 Detail Record (Transaction)
Page 137 and 138:
Page 139 and 140:
Page 141 and 142:
Page 143 and 144:
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
F.23.2 Detail Record (Transaction)
Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164: Plan Communications User Guide Appe
Page 169 and 170: Item # Plan Communications User Gui
Page 171 and 172: F.28.3 Trailer Record Plan Communic
Page 213: Plan Communications User Guide Appe
Page 265 and 266:
Page 267 and 268:
Page 269 and 270:
I.3 Obsolete Transaction Reply Code
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
Page 297 and 298:
Page 299 and 300:
Page 301 and 302:
Page 303 and 304:
Page 305 and 306:
Page 307 and 308:
Page 309 and 310:
Page 311 and 312:
Page 313 and 314:
Page 315 and 316:
Page 317 and 318:
Page 319 and 320:
Page 321 and 322:
Page 323 and 324:
Page 325 and 326:
Page 327 and 328:
Page 329 and 330:
Page 331 and 332:
Page 333 and 334:
Page 335 and 336:
Page 337 and 338:
Page 339 and 340:
Page 341 and 342:
CMS Transmittals to the Plans Plan
Page 343 and 344:
Page 345 and 346:
ID# Transmittal Monthly Transmittal
Page 347 and 348:
ID# Transmittal Monthly Transmittal
Page 349 and 350:
Page 351 and 352:
Page 353 and 354:
Page 355 and 356:
show all

Medicare Advantage and Prescription Drug Plans December 28 ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?