Medicare Advantage and Prescription Drug Plans December 28 ...
Medicare Advantage and Prescription Drug Plans December 28 ...
Medicare Advantage and Prescription Drug Plans December 28 ...
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Plan Communications User Guide Appendices, Version 6.3<br />
F.22 BEQ Response File .......................................................................................................... F-109<br />
F.22.1 Header Record ................................................................................................ F-109<br />
F.22.2 Detail Record (Transaction) ........................................................................... F-110<br />
F.22.3 Trailer Record ................................................................................................ F-121<br />
F.23 MA Full Dual Auto Assignment Notification File .......................................................... F-122<br />
F.23.1 Header Record ................................................................................................ F-122<br />
F.23.2 Detail Record (Transaction) ........................................................................... F-123<br />
F.23.3 Trailer Record ................................................................................................. F-123<br />
F.24 Auto Assignment (PDP) Address Notification File......................................................... F-125<br />
F.24.1 Header Record ................................................................................................ F-125<br />
F.24.2 Detail Record .................................................................................................. F-126<br />
F.24.3 Trailer Record ................................................................................................ F-1<strong>28</strong><br />
F.25 Plan Payment Report (PPR)/Interim Plan Payment Report (IPPR) Data File .......... F-129<br />
F.25.1 Header Record .......................................................................................... F-129<br />
F.25.2 Capitated Payment – Current Activity ...................................................... F-130<br />
F.25.3 Premium Settlement .................................................................................. F-131<br />
F.25.4 Fees ........................................................................................................... F-131<br />
F.25.5 Special Adjustments ................................................................................. F-132<br />
F.25.6 Previous Cycle Balance Summary ............................................................ F-133<br />
F.25.7 Payment Summary ........................................................................................ F-134<br />
F.25.8 Payment Balance Carried Forward ............................................................... F-136<br />
F.26 Long-Term Institutionalized (LTI) Resident Report Data File ................................. F-138<br />
F.27 Agent Broker Compensation Report Data File ......................................................... F-140<br />
F.<strong>28</strong> Monthly <strong>Medicare</strong> Second Payer (MSP) Information Data File ............................... F-142<br />
F.<strong>28</strong>.1 Header Record ....................................................................................... F-142<br />
F.<strong>28</strong>.2 Detail Record ........................................................................................ F-142<br />
F.<strong>28</strong>.3 Trailer Record ........................................................................................ F-143<br />
F.29 Other Health Coverage Information Data File ......................................................... F-144<br />
F.29.1 Header Record ....................................................................................... F-144<br />
F.29.2 Detail Record ........................................................................................ F-144<br />
F.29.3 Trailer Record ........................................................................................ F-149<br />
F.30 No Premium Due Data File Layout .......................................................................... F-150<br />
F.31 Failed Payment Reply Report (FPRR) Data File ............................................................. F-152<br />
F.32 Missing Payment Exception Report (MPER) Data File ............................................ F-153<br />
G: Screen Hierarchy ................................................................................................................. G-1<br />
H: Validation Messages ............................................................................................................ H-1<br />
I: Codes ........................................................................................................................................ I-1<br />
I.1 Transaction Codes .......................................................................................................... I-1<br />
I.2 Transaction Reply Codes ................................................................................................ I-2<br />
<strong>December</strong> <strong>28</strong>, 2012 vii Table of Contents