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CSSC Operations
/ Medicare Medicaid Plans / FAQs
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Palmetto GBA Home
CSSC Operations
/ Medicare Medicaid Plans
FAQs
Medicare Medicaid Plans
FAQs
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How will MMPs test with Medicare and State agencies on an end-to-end integration test?
04/15/2014
In those cases where no NPI is submitted for a specific encounter, will Medicare leave this alone or provide a default value?
04/15/2014
What file naming conventions will be in place for data sent to the State agencies?
04/15/2014
What is the naming convention that MMPs use for these Medicaid data submissions?
04/15/2014
When will a test file be available to show State agencies the exact implementation of the interface between Medicare and State agencies?
04/15/2014
When you say “unique plan id”, you are referring to the MMPs 5 position H contract number, correct?
04/15/2014
Will data rejected by Medicare be omitted from the data sent to State agencies?
04/15/2014
Will data sent to State agencies consist of data submitted by multiple MMPs in a single consolidated file?
04/15/2014
Will data sent to State agencies, be separated by submitting plan? Either they will send a consolidated file or will send separate files per submitter. Presuming they will send a consolidate single file per day, where the data is identified at a high level loop per submitter. Please confirm if this is the case and where the iteration will be based (loop-wise).
04/15/2014
Will encounters from the same billing provider be grouped together?
04/15/2014
Will ISA08 equal GS03 (80892 for Medicaid)?
04/15/2014
Will Medicare make any changes to the data submitted by an MMP prior to State agencies receiving it?
04/15/2014
Will Medicare require State agencies to respond to Medicare with an audit file? If so, in what format. Is this still necessary or required?
04/15/2014
Will MMP use Addendum to Encounter Data System Companion Guide and State Assigned Medicaid Companion Guides Version Number 2.0, dated November 15, 2013 (CSSCOperations.com) – specifically sections 4.0 and 5.0?
04/15/2014
Will Palmetto group encounters from the same MMP together?
04/15/2014
With the exception of those fields referenced in sections 4.0 and 5.0, will the MMP use the State agencies provided companion guide for all remaining data elements?
04/15/2014
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