Medicare Advantage and Prescription Drug Plans December 28 ...

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Plan Communications User Guide Appendices, Version 6.3 ID# Transmittal CMS Transmittals to the Plans Description Responsible System Type Freq. Dataset Naming Conventions 27 Front-End Risk Adjustment System (FERAS) Response Reports Transaction Summary Report Report contains all of the transactions submitted, whether accepted or rejected. FERAS Report Daily Gentran Mailbox/TIBCO MFT Internet Server: RPT.RAPS_SUMMARY_ssssss Connect:Direct: TRANSMITTED FROM PALMETTO 28 Front-End Risk Adjustment System (FERAS) Response Reports Duplicate Diagnosis Cluster Report Report identifies diagnosis clusters with 502 error message, clusters accepted, but not stored. FERAS Report Daily Gentran Mailbox/TIBCO MFT Internet Server: RPT.RAPS_DUPDX_RPT_ssssss Connect:Direct: TRANSMITTED FROM PALMETTO Gentran Mailbox/TIBCO MFT Internet Server: 29 Transaction Reply Daily Activity Data File PCUG Record Layout – F.14 Data file version of the Transaction Reply Daily Activity Report. MARx Data File Daily P.Rxxxxx.DTRRD.Dyymmdd.Thhm msst.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx.DTRRD.Dyymmdd .Thhmmsst Connect:Direct (Non-Mainframe): [directory]Rxxxxx.DTRRD.Dyymmd d.Thhmmsst 30 Electronic Data Services (EDS) Response Data File File containing responses if files are accepted or rejected. EDS Data File Daily Gentran Mailbox/TIBCO MFT Internet Server: P.xxxxx.EDS_RESPONSE.pn Connect:Direct: TRANSMITTED FROM PALMETTO 31 Electronic Data Services (EDS) Reject IC ISAIEA Data File File containing responses if files are accepted or rejected. EDS Data File Daily Gentran Mailbox/TIBCO MFT Internet Server: P.xxxxx.EDS_REJT_IC_ISAIEA.pn Connect:Direct: TRANSMITTED FROM PALMETTO Gentran Mailbox/TIBCO MFT Internet Server: 32 Electronic Data Services (EDS) Reject Function Transaction Data File File containing responses if files are accepted or rejected. EDS Data File Daily P.xxxxx.EDS_REJT_FUNCT_TRAN S.pn Connect:Direct: TRANSMITTED FROM PALMETTO Gentran Mailbox/TIBCO MFT Internet Server: 33 Electronic Data Services (EDS) Accept Function Transaction Data File File containing responses if files are accepted or rejected. EDS Data File Daily P.xxxxx.EDS_ACCPT_FUNCT_TR ANS.pn Connect:Direct: TRANSMITTED FROM PALMETTO ID# Transmittal Description Responsible Type Freq. Dataset Naming Conventions December 28, 2012 K-6 All Transmissions Overview
CMS Transmittals to the Plans Plan Communications User Guide Appendices, Version 6.3 System Gentran Mailbox/TIBCO MFT Internet Server: 34 Electronic Data Services (EDS) Response Claim Number Data File File containing responses if files are accepted or rejected. EDS Data File Daily P.xxxxx.EDS_RESP_CLAIM_NUM. pn Connect:Direct: TRANSMITTED FROM PALMETTO Weekly Transmittals (Data & Reports) 35 LIS/Part D Premium Data File PCUG Record Layout – F.18 The data in the report reflects LIS info, premium subsidy levels, Low-income co-pay levels, etc. for all Beneficiaries who have a low-income designation enrolled in a Plan. This data file is produced bi-weekly. It is not automatically transmitted to the Plans. Through the MARx UI plans can request or reorder this data file. MARx Data File Biweekly Gentran Mailbox/TIBCO MFT Internet Server: P.Rxxxxx.LISPRMD.Dyymmdd.Thh mmsst.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx.LISPRMD.Dyymm dd.Thhmmsst Connect:Direct (Non-Mainframe): [directory]Rxxxxx.LISPRMD.Dyym mdd.Thhmmsst Monthly Transmittals (Data & Reports) Gentran Mailbox/TIBCO MFT Internet Server: 36 Part C Monthly Membership Detail Report (Non Drug Report) aka: Monthly Membership Report (MMR) PCUG Sample Report – J.5 Report listing every Part C Medicare member of the contract and providing details about the payments and adjustments made for each. Note: The date in the file name defaults to “01” denoting the first day of the current payment month MARx Report Monthly P.Fxxxxx.MONMEMR.Dyymm01.T hhmmsst.pn P.Rxxxxx.MONMEMR.Dyymm01.T hhmmsst.pn Connect:Direct (Mainframe): zzzzzzzz.Fxxxxx.MONMEMR.Dyy mm01.Thhmmsst zzzzzzzz.Rxxxxx.MONMEMR.Dyy mm01.Thhmmsst Connect:Direct (Non-Mainframe): [directory]Fxxxxx.MONMEMR.Dyy mm01.Thhmmsst zzzzzzzz.Rxxxxx.MONMEMR.Dyy mm01.Thhmmsst December 28, 2012 K-7 All Transmissions Overview
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Item # Plan Communications User Gui
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I.3 Obsolete Transaction Reply Code
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Medicare Advantage and Prescription Drug Plans December 28 ...

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