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Medicare Medicaid Plans
FAQs
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In what position on the NCPDP file will CMS populate the CMS assigned number for each claim?10/28/2014
Is CMS expecting the value that was provided in Field 896 in the NCPDP PAH 4.2 pharmacy encounter file to be used for credit/debit transactions after the claim has been processed?10/28/2014
Will CMS send back rejects on the NCPDP file for compounds under the DE or will we see the CD identifier starting in position 47?10/28/2014
Will more than 1 response line be sent per claim on the NCPDP file if there are both detail and compound rejects?10/28/2014
Does CMS/Palmetto perform compliance validation on 837 files received from ICOs for Medicaid services?07/09/2014
If a single Medicare encounter is rejected will the HLs be renumbered to be in sequence?07/09/2014
If a single Medicare encounter is rejected will the ST/SE count be recalculated to reflect the new count for the transaction?07/09/2014
If multiple encounters for a subscriber exists and rejecting a Medicaid claim, would all loops/segments pertaining to the encounter be rejected and therefore deleted from the file being sent to the State, starting with 2300:CLM up to the next 2300:CLM?07/09/2014
If multiple Medicare encounters for a subscriber exists and there is a encounter being rejected, would all loops/segments pertaining to the encounter be rejected and therefore deleted from the file sent to the State, starting with 2300:CLM up to the next 2300:CLM?07/09/2014
If rejecting a single encounter for a single subscriber and a single billing provider, would all loops/segments pertaining to the Medicaid encounter be rejected and therefore deleted from the file being sent to the State, starting with ST and up to SE?07/09/2014
If rejecting a single encounter for a single subscriber, would all loops/segments pertaining to the Medicaid encounter be rejected and therefore deleted from the file being sent to the State, starting with the billing provider HL and up to the next HL (next subscriber or billing provider)?07/09/2014
If rejecting a single encounter for a subscriber, would all loops/segments pertaining to the Medicaid encounter be rejected and therefore deleted from the file being sent to the State, starting with the subscriber HL and up to the next HL (next subscriber or billing provider)?07/09/2014
If rejecting a single encounter for a subscriber, would all loops/segments pertaining to the Medicaid encounter be rejected and therefore deleted from the file being sent to the State, starting with the subscriber HL and up to the next HL (next subscriber or billing provider)?07/09/2014
If rejecting a single Medicare encounter for a single subscriber and a single billing provider, would all loops/segments pertaining to the encounter be rejected, starting with ST and up to SE?07/09/2014
If rejecting a single Medicare encounter for a single subscriber, would all loops/segments pertaining to the encounter be rejected and therefore deleted from the file sent to the State, starting with the billing provider HL and up to the next HL (next subscriber or billing provider)?07/09/2014
If rejecting a single Medicare encounter for a subscriber, would all loops/segments pertaining to the encounter be rejected and therefore deleted from the file sent to the State, starting with the subscriber HL and up to the next HL (next subscriber or billing provider)?07/09/2014
If rejecting at the claim level for the Medicaid file, is the compliant portion reformatted to a compliant 837 transaction?07/09/2014
If rejecting only the non-compliant portion of the Medicaid file, is the rejection at the transaction (ST – SE), or claim level?07/09/2014
If rejecting the last encounter for the subscriber, would all loops/segments pertaining to the Medicaid encounter be rejected and therefore deleted from the file being sent to the State, starting with 2300:CLM up to the next HL (next subscriber or billing provider)?07/09/2014
If rejecting the last Medicare encounter for the subscriber, would all loops/segments pertaining to the encounter be rejected and therefore deleted from the file sent to the State, starting with 2300:CLM up to the next HL (next subscriber or billing provider)?07/09/2014
If rejecting the last Medicare encounter for the subscriber, would all loops/segments pertaining to the encounter be rejected and therefore deleted from the file sent to the State, starting with 2300:CLM up to the next HL (next subscriber or billing provider)?07/09/2014
In the event of a compliance failure on the Medicaid file does CMS/Palmetto reject the non-compliant portion of the file or the entire file?07/09/2014
Will the NCPDP file be part of the audit tracking?07/09/2014
For transaction identification purposes, State agencies will need a complete list of Submitter-IDs as referenced in the above document for ISA06, GS02, and 1000A NM109. In order for State agencies to identify which MMP submitted which data State agencies would need to know which plan codes belong to which MMPs, hence our request for a complete list of plan codes (submitter ids) and their associated owners.04/15/2014
How long will it take from Medicare receipt of the submitted MMP encounter data to when this data is posted to State agencies?04/15/2014
see 25 | see 50 | see 100 Next Page >>