Medicare Advantage and Prescription Drug Plans December 28 ...

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Plan Communications User Guide Appendices, Version 6.3 Item Segment Data Element Description Length Type Contents 2320A ADX02 Adjustment Reason Code 2/2 ID “H1” - Information forthcoming – detailed information related to the adjustment is provided through a separate mechanism F.1.3 Trailer Record Item Segment Data Element Description Length Type Contents Summary 820 Trailer AN “SE” SE01 Number of Included Segments 1/10 N0 “11” SE02 Transaction Set Control Number 4/9 AN Use control number, same as in 820 Header. December 28, 2012 F-6 820 Format Payment Advice Data File
Plan Communications User Guide Appendices, Version 6.3 F.2 Batch Completion Status Summary (BCSS) Data File As of the April 2011 release, the Batch Completion Status Summary (BCSS) file is a hybrid file that communicates the status of file transmissions, as well as reporting and reports on submitted transaction records that failed due to formatting issues. Previously, this file also returned the processing results of accepted and rejected transactions, but as of the April 2011 release, those are reported only on the Daily Transaction Reply Report (DTRR) Data file. Note: The Enrollment Transmission Message File (STATUS) discontinued as of the April 2011 Release. This data file is sent to the submitter after a batch of submitted transactions is processed. It provides a count of all transactions within the batch and details the number of rejected and accepted transactions. It also provides an image of each failed transaction. F.2.1 Failed Record Below, the example of a BCSS report displays the format of the file transmission status. Plans get a sense of how the file status incorporates the new Transaction Codes (TCs) 76 through 83 and that the counts for accepted, rejected and failed transactions are displayed. Beginning of Message Text H1 TRANSACTIONS RECEIVED ON 2012-03-27 AT 16.59.49 H2 TRANSACTIONS PROCESSED ON 2012-03-27 AT 17.03.50 H3 ENROLLMENT PROCESSING COMPLETED H4 HEADER CODE= AAAAAAHEADER H5 HEADER DATE= 032012 H6 REQUEST ID = H7 BATCH ID = 0123456789 H8 USER ID = X7YZ C1 TRAN CNTS1 = 00000019 T01 0000000 T51 0000000 T61 0000000 T72 0000001 C2 TRAN CNTS2 = T73 0000002 T74 0000000 T75 0000000 T76 0000000 C3 TRAN CNTS3 = T77 0000000 T78 0000000 T79 0000002 T80 0000002 C4 TRAN CNTS4 = T81 0000003 T82 0000004 T83 0000005 TXX 0000000 P1 TOTAL TRANSACTIONS PROCESSED= 00000043 P2 TOTAL ACCEPTED TRANSACTIONS = 00000041 P3 TOTAL REJECTED TRANSACTIONS = 00000002 P4 TOTAL FAILED TRANSACTIONS = 00000000 F………………failed transaction text image……………… End of Message Text All BCSS records begin with a two-character record type identifier. The first character designates the type of data reported in that section. December 28, 2012 F-7 BCSS Data File
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I.3 Obsolete Transaction Reply Code
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CMS Transmittals to the Plans Plan
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ID# Transmittal Monthly Transmittal
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Medicare Advantage and Prescription Drug Plans December 28 ...

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