Medicare Advantage and Prescription Drug Plans December 28 ...

Plan Communications User Guide Appendices, Version 6.3
F.22 BEQ Response File .......................................................................................................... F-109
F.22.1 Header Record ................................................................................................ F-109
F.22.2 Detail Record (Transaction) ........................................................................... F-110
F.22.3 Trailer Record ................................................................................................ F-121
F.23 MA Full Dual Auto Assignment Notification File .......................................................... F-122
F.23.1 Header Record ................................................................................................ F-122
F.23.2 Detail Record (Transaction) ........................................................................... F-123
F.23.3 Trailer Record ................................................................................................. F-123
F.24 Auto Assignment (PDP) Address Notification File......................................................... F-125
F.24.1 Header Record ................................................................................................ F-125
F.24.2 Detail Record .................................................................................................. F-126
F.24.3 Trailer Record ................................................................................................ F-128
F.25 Plan Payment Report (PPR)/Interim Plan Payment Report (IPPR) Data File .......... F-129
F.25.1 Header Record .......................................................................................... F-129
F.25.2 Capitated Payment – Current Activity ...................................................... F-130
F.25.3 Premium Settlement .................................................................................. F-131
F.25.4 Fees ........................................................................................................... F-131
F.25.5 Special Adjustments ................................................................................. F-132
F.25.6 Previous Cycle Balance Summary ............................................................ F-133
F.25.7 Payment Summary ........................................................................................ F-134
F.25.8 Payment Balance Carried Forward ............................................................... F-136
F.26 Long-Term Institutionalized (LTI) Resident Report Data File ................................. F-138
F.27 Agent Broker Compensation Report Data File ......................................................... F-140
F.28 Monthly Medicare Second Payer (MSP) Information Data File ............................... F-142
F.28.1 Header Record ....................................................................................... F-142
F.28.2 Detail Record ........................................................................................ F-142
F.28.3 Trailer Record ........................................................................................ F-143
F.29 Other Health Coverage Information Data File ......................................................... F-144
F.29.1 Header Record ....................................................................................... F-144
F.29.2 Detail Record ........................................................................................ F-144
F.29.3 Trailer Record ........................................................................................ F-149
F.30 No Premium Due Data File Layout .......................................................................... F-150
F.31 Failed Payment Reply Report (FPRR) Data File ............................................................. F-152
F.32 Missing Payment Exception Report (MPER) Data File ............................................ F-153
G: Screen Hierarchy ................................................................................................................. G-1
H: Validation Messages ............................................................................................................ H-1
I: Codes ........................................................................................................................................ I-1
I.1 Transaction Codes .......................................................................................................... I-1
I.2 Transaction Reply Codes ................................................................................................ I-2
December 28, 2012 vii Table of Contents