Medicare Advantage and Prescription Drug Plans December 28 ...

More documents

Recommendations

Info

Plan Communications User Guide Appendices, Version 6.3 013 A DISENROLLMENT ACCEPTED AS SUBMITTED DISENROLLMENT TRC GROUPING 014 A DISENROLLMENT DUE TO ENROLLMENT IN ANOTHER PLAN 018 A AUTOMATIC DISENROLLMENT 025 A DISENROLLMENT ACCEPTED, CLAIM NUMBER CHANGE 026 A DISENROLLMENT ACCEPTED, NAME CHANGE 050 R DISENROLLMENT REJECTED, NOT ENROLLED 051 R DISENROLLMENT REJECTED, INCORRECT EFFECTIVE DATE 052 R DISENROLLMENT REJECTED, DUPLICATE TRANSACTION 054 R DISENROLLMENT REJECTED, RETROACTIVE EFFECTIVE DATE 090M 104R 105R 108R 114R 120A DATE OF DEATH ESTABLISHED REJECTED; INVALID OR MISSING ELECTION TYPE REJECTED; INVALID EFFECTIVE DATE FOR ELECTION TYPE REJECTED; ELECTION LIMITS EXCEEDED DRUG COVERAGE CHANGE REJECTED; NOT AEP PREMIUM PAYMENT OPTION CHANGE SENT TO W/H AGENCY 151 I DISENROLLMENT ACCEPTED, INVALID DISENR REASON CODE 205 I INVALID DISENROLLMENT REASON CODE 036R 042R 044R 116R 284R 288A 289R 291I 296R 292R 110R 127R 128R 129I 139A 162R 164R 189A DISENROLLMENT CANCELLATION TRC GROUPING TRANSACTION REJECTED BENEFICIARY IS DECEASED TRANSACTION REJECTED, BLOCKED TRANSACTION REJECTED, OUTSIDE CONTRACT PERIOD ENROLLMENT OR CHANGE REJECTED; INVALID SEGMT NUM CANCELLATION REJECTED, ENROLL/DISENROLL CANCELLATION DISENROLLMENT CANCELLATION ACCEPTED DISENROLLMENT CANCELLATION REJECTED ENROLLMENT REINSTATED, DISENROLLMENT CANCELLATION DISENROLL CANCEL REJECTED, REINSTATEMENT CONFLICT (CONFLICTS WITH AN EXISTING ENROLLMENT) DISENROLLMENT TRANSACTION (TC 51) Rejected when used to attempt an enrollment Cancellation DISENROLLMENT REJECTED, WAS CANCELLATION ATTEMPT EGHP TRC GROUPING REJECTED; NO PART A AND NO EGHP ENROLLMENT WAIVER PART D ENROLLMENT REJECTED, EMPLOYER SUBSIDY PART D ENROLL REJECT, EMPLYR SBSDY SET: NO PRIOR TRN PART D ENROLL ACCEPT, EMP SBSDY SET: PRIOR TURN REJECT EGHP FLAG CHANGE ACCEPTED INVALID EGHP FLAG VALUE EGHP FLAG VALUE NOT 'Y' NO CHANGE IN EGHP FLAG December 28, 2012 I-93 TRC Groupings
Plan Communications User Guide Appendices, Version 6.3 ENROLLMENT RECON TRC GROUPING 600R UI TRANSACTION OVERRIDE 601R CASEWORK BENEFICIARY 602R NO DISCREPANCY 603R 2007 DATE IS NOT VALID 604A DISENROLLMENT 605R RECON TRANSACTION DENIED 606I DIRECT BILL 607A ENROLLMENT ACCEPTED AS SUBMITTED 608A ENROLLMENT ACCEPTED WITH CMS ESTABLISHED EFFECTIVE AND CMS END DATE 609A ENROLLMENT ACCEPTED WITH CMS ESTABLISHED EFFECTIVE 610A ENROLLMENT ACCEPTED WITH CMS ESTABLISHED END DATE 611R NO DISCREPANCY IN 2006 ENROLLMENT TRC GROUPING 011 A ENROLLMENT ACCEPTED AS SUBMITTED 015 A ENROLLMENT CANCELED 016 I ENROLLMENT ACCEPTED, OUT OF AREA 017 I ENROLLMENT ACCEPTED, PAYMENT DEFAULT RATE 019 R ENROLLMENT REJECTED- NO PART- A & PART-B ENTITLEMENT 020 R ENROLLMENT REJECTED-PACE UNDER 55 032 R ENROLLMENT REJECTED, BENEFICIARY NOT ENTIT PART B 033 R ENROLLMENT REJECTED, BENEFICIARY NOT ENTIT PART A 034 R ENROLLMENT REJECTED, BENEFICIARY IS NOT AGE 65 035 R ENROLLMENT REJECTED, BENEFICIARY IS IN HOSPICE 036 R TRANSACTION REJECTED, BENEFICIARY IS DECEASED 038 R ENROLLMENT REJECTED, DUPLICATE TRANSACTION 039 R ENROLLMENT REJECTED, CURRENTLY ENOLL IN SAME PLAN 042 R TRANSACTION REJECTED, BLOCKED 044 R TRANSACTION REJECTED, OUTSIDE CONTRACT PERIOD 045 R ENROLLMENT REJECTED, BENEFICIARY IS IN ESRD 056R DEMONSTRATION ENROLLMENT REJECTED 100 A PBP CHANGE ACCEPTED AS SUBMITTED 102 R REJECTED; INCORRECT OR MISSING APPLICATION DATE 103 R ICEP/IEP ELECTION, MISSING A/B ENTITLEMENT DATE 104R REJECTED; INVALID OR MISSING ELECTION TYPE 105R REJECTED; INVAILD EFFECTIVE DATE FOR ELECTION TYPE 106R REJECTED; ANOTHER TRANSACTION RECEIVED WITH LATER APPLICATION DATE 108R REJECTED; ELECTION LIMITS EXCEEDED 114R DRUG COVERAGE CHANGE REJECTED; NOT AEP 116R ENROLLMENT OR CHANGE REJECTED; INVALID SEGMT NUM 120A PREMIUM PAYMENT OPTION CHANGE SENT TO W/H AGENCY 124R ENROLLMENT/CHANGE REJECTED; INVALID UNCOVERED MONTHS 126R ENROLLMENT/CHANGE REJECTED; INVALID CRED CVRG FLAG December 28, 2012 I-94 TRC Groupings
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:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Item # Plan Communications User Gui
Page 171 and 172:
F.28.3 Trailer Record Plan Communic
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211 and 212:
Page 213 and 214:
Page 215 and 216:
Page 217 and 218:
Page 219 and 220:
Page 221 and 222:
Page 223 and 224:
Page 225 and 226:
Page 227 and 228: Plan Communications User Guide Appe
Page 269 and 270: I.3 Obsolete Transaction Reply Code
Page 277: Plan Communications User Guide Appe
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?