Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
Code Type Title Short Definition Definition
712 A UI Moved
End Date
Later
713 A UI Removed
Enrollment
End Date
714 I UI Part D
Opt-Out
Change
Accepted
UI LATE END DT
UI REMVD END
DT
UI OPT OUT OK
A CMS User updated the end date of an existing enrollment to a later date. This reply has a
Transaction Type of 61. The new end date is reported in field 18 (effective date) and the original
end date is reported in TRR data record field 24. The existing enrollment was extended to end on
the date in TRR data record field 18. The start date of the existing enrollment remains unchanged.
The Part C Premium amount may have been populated automatically with the base Part C premium
amount.
Plan Action: Locate the enrollment for this beneficiary that ends on the date in field 24. Update
the Plan records for this enrollment to end on the date in field 18. Verify the Part C premium
amount and submit a Record Update transaction if necessary. Take the appropriate actions as per
CMS enrollment guidance.
A CMS User removed the end date from an existing enrollment. This reply has a Transaction Type
of 61. TRR data record field 18 (effective date) contains zeroes (00000000) and the original end
date is reported in field 24. The existing enrollment was extended to be an open-ended enrollment.
The start date of the existing enrollment remains unchanged.
The Part C Premium amount may have been populated automatically with the base Part C premium
amount.
Plan Action: Locate the enrollment for this beneficiary that ends on the date in TRR data record
field 24. Update the Plan records for this enrollment to remove the end date and to extend this
enrollment to be an open-ended enrollment. Verify the Part C premium amount and submit a
Record Update transaction if necessary. Take the appropriate actions as per CMS enrollment
guidance.
A CMS User or Plan User with Update Authority added or changed the value of the Part D Opt-Out
Flag for this beneficiary. The new Opt-Out Flag is reported in TRR data record field 38 on the TRR
record.
Plan Action: Update the Plan’s records accordingly.
December 28, 2012 I-80 Transaction Reply Codes (TRCs)