Medicare Advantage and Prescription Drug Plans December 28 ...

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ID# Transmittal Quarterly Report 72 Front-End Risk Adjustment System (FERAS) Response Reports Frequency Report Quarterly Report Missing Payment Exception Report Data Record Layout Plan Communications User Guide Appendices, Version 6.3 Description Report provides quarterly summary of all errors on all file submissions within the three-month quarter. Data file reporting payment actions which failed to complete. Responsible System Type Freq. Dataset Naming Conventions FERAS Report Quarterly MARx Data File Monthly Payment Cycle Gentran Mailbox/TIBCO MFT Internet Server: RAPS_ERRORFREQ_QTR_ssssss Connect:Direct: TRANSMITTED FROM PALMETTO Gentran Mailbox/TIBCO MFT Internet Server: 73 Yearly Report P.Rxxxxx.MPERD.Dyymmdd.Thhm msst.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx. MPERD.Dyymmdd.Thhmmsst Connect:Direct (Non-Mainframe): [directory]Rxxxxx. MPERD.Dyymmdd.Thhmmsst Gentran Mailbox/TIBCO MFT Internet Server: 74 RAS Final Yearly Model Output Report, Part D Report indicates the year-end Part D risk adjustment factors for each beneficiary. MARx forwards this report, produced by RAS, to Plans as part of the month-end processing. RAS (MARx) Report (.pdf) Yearly P.Rxxxxx.PTDMOFR.Yeeee.Cvvvvv .Thhmmss.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx.PTDMOFR.Yeeee. Cvvvvv.Thhmmss Connect:Direct (Non-Mainframe): [directory]Rxxxxx.PTDMOFR. Yeeee.Cvvvvv.Thhmmss Gentran Mailbox/TIBCO MFT Internet Server: 75 RAS Final Yearly Model Output Data File, Part D Data file version of the year end Part D RAS Model Output Report. MARx forwards this report, produced by RAS, to Plans as part of the month-end processing. RAS (MARx) Data File Yearly P.Rxxxxx.PTDMOFD.Yeeee.Cvvvvv .Thhmmss.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx.PTDMOFD.Yeeee. Cvvvvv.Thhmmss Connect:Direct (Non-Mainframe): [directory]Rxxxxx.PTDMOFD.Yeeee .Cvvvvv.Thhmmss Gentran Mailbox/TIBCO MFT Internet Server: 76 RAS Final Yearly Model Output Report, Part C Report indicates the year end Part C risk adjustment factors for each beneficiary. MARx forwards this report, produced by RAS, to Plans as part of the month-end processing. RAS (MARx) Report (.pdf) Yearly P.Rxxxxx.HCCMOFR.Yeeee.Cvvvv v.Thhmmss.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx.HCCMOFR.Yeeee. Cvvvvv.Thhmmss Connect:Direct (Non-Mainframe): [directory]Rxxxxx.HCCMOFR.Yeee e.Cvvvvv.Thhmmss December 28, 2012 K-16 All Transmissions Overview
Plan Communications User Guide Appendices, Version 6.3 ID# Transmittal Yearly Report Description Responsible System Type Freq. Dataset Naming Conventions Gentran Mailbox/TIBCO MFT Internet Server: 77 RAS Final Yearly Model Output Data File, Part C Data file version of the year end Part C RAS Model Output Report. MARx forwards this report, produced by RAS, to Plans as part of the month-end processing. RAS (MARx) Data File Yearly P.Rxxxxx.HCCMOFD.Yeeee.Cvvvv v.Thhmmss.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx.HCCMOFD.Yeeee. Cvvvvv.Thhmmss Connect:Direct (Non-Mainframe): [directory]Rxxxxx.HCCMOFD.Yeee e.Cvvvvv.Thhmmss 78 Loss of Subsidy Data File PCUG Record Layout – F.17 79 PDP Loss Data File 80 PDP Gain Data File The first file is sent in September and identifies members receiving a joint CMS and SSA letter informing them they will not have Deemed status for the following year. The second file is sent in December and is an updated version of the September file, indicating those Beneficiaries who still do not have Deemed status for the following year. The data file has a record length of 500 bytes. The TRC used for this special file type is 996. TRC 996 indicates the loss of Deeming which means the Beneficiary will not be redeemed for the upcoming period. Once a year notification file sent by CMS providing a preliminary listing of LIS-eligible Beneficiaries whom CMS reassigns to a new PDP or to a new PBP within the same plan sponsor effective January 1, 2008. The LOSS file notifies PDPs of the members they will lose as a result of reassignment to other Plans. These members are classified as losing members. Once a year notification file, sent by CMS, provides a preliminary listing of LIS-eligible Beneficiaries whom CMS reassigns to a new PDP or to a new PBP within the same Plan sponsor effective January 1, 2008. The GAIN file notifies PDPs of members they will gain as a result of the yearly reassignment. These members are classified as gaining members. MARx Data File Twice Yearly MBD Data File Yearly MBD Data File Yearly Gentran Mailbox/TIBCO MFT Internet Server: P.Rxxxxx.EOYLOSD.Dyymmdd.Th hmmsst.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx.EOYLOSD.Dyym mdd.Thhmmsst Connect:Direct (Non-Mainframe): [directory]Rxxxxx.EOYLOSD.Dyym mdd.Thhmmsst Gentran Mailbox/TIBCO MFT Internet Server: P.Rxxxxx.APDP5.LOSS.Dyymmdd. Thhmmsst.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx.APDP5.LOSS.Dyy mmdd.Thhmmsst Connect:Direct (Non-Mainframe): [directory]Rxxxxx.APDP5.LOSS.Dy ymmdd.Thhmmsst Gentran Mailbox/TIBCO MFT Internet Server: P.Rxxxxx.APDP5.GAIN.Dyymmdd. Thhmmsst.pn Connect:Direct (Mainframe): zzzzzzzz.Rxxxxx.APDP5.GAIN.Dyy mmdd.Thhmmsst Connect:Direct (Non-Mainframe): [directory]Rxxxxx.APDP5.GAIN.Dy ymmdd.Thhmmsst December 28, 2012 K-17 All Transmissions Overview
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I.3 Obsolete Transaction Reply Code
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