Adds. Using the beneficiary's HICN, the incoming record is compared to the database to attempt to match on previously submitted records. The data elements comprising the set of initial matching criteria consist of the HICN, Effective Date, Insurance Type, and PAP ID. If a match of these fields cannot be made on the existing database, the incoming record is considered an "add" (a new record). If incoming field matches indicate a record is not an Add, additional fields are compared to determine if the incoming record should be considered an update. These fields include Toll-Free Number, Coverage Type, and Termination Date. If any of these fields have changed from the previous month's submission the record is considered an update. If the incoming record matches exactly on these additional fields, no action is taken and the PAP does not receive a response for this record. Any records previously added, but not now included in the PAP's current Input File submission will be deleted from the COBC’s PAP records. Note: During the course of production data exchange involving current PAP clients this delete process should only be used to remove a record that never should have been sent to CMS, one that should not have been added to our database originally. A beneficiary record that has been correctly added is required to be kept active for the entire period that the Medicare beneficiary continues to be receiving services from the PAP. Periods of "continuous enrollment" may include PAP disenrollment/re-enrollment activity that doesn't result in actual termination from PAP services (for example, periodic automatic reenrollment). Once a Medicare beneficiary's PAP enrollment ends and after the PAP sends CMS an accepted "Termination Date" in a subsequent Input File (see the Input File, Field #8), we do not require the PAP to continue to include that beneficiary's information on later Input Files. However, we recommend that a PAP consider continuing to include former PAP enrollee data on later Input Files for a period of time determined to be of value to the PAP. Previous PAP enrollee data that is omitted from a later Input File will be a "Delete," and will cause all evidence of PAP enrollment to disappear from the beneficiary's record on the CMS database. Because such deleted data cannot be recovered there will no longer be any record of PAP – CMS data sharing at CMS. If a PAP determines there is value in keeping the record of a Medicare beneficiary's PAP activity available on the CMS database, the PAP should continue to include the beneficiary's data on subsequent PAP Input Files. Records containing errors are returned to the PAP with the appropriate error code on the response record linked to the erroneous input data. The PAP should identify and correct the error, and resubmit the record with the next month's regular Input File. When processing of incoming data is complete, a file is created and transmitted to the MBD containing the adds, updates, and delete records generated by the COBC from the Input File submitted by the PAP. The MBD returns a file to the COBC containing Part D enrollment information. Within 15 days of the PAP Input File submission, the COBC generates and transmits a Response File to the PAP. This file contains responses for any records that were added, updated, or deleted. The file does not contain responses for records to which no change was made. The Response File also contains the Part D enrollment information received from the MBD.
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Adds. Using the beneficiary's HICN, the incoming record is compared to the database to attempt to match on previously submitted records. The data elements comprising the set of initial matching criteria consist of the HICN, Effective Date, Insurance Type, and PAP ID. If a match of these fields cannot be made on the existing database, the incoming record is considered an "add" (a new record). If incoming field matches indicate a record is not an Add, additional fields are compared to determine if the incoming record should be considered an update. These fields include Toll-Free Number, Coverage Type, and Termination Date. If any of these fields have changed from the previous month's submission the record is considered an update. If the incoming record matches exactly on these additional fields, no action is taken and the PAP does not receive a response for this record. Any records previously added, but not now included in the PAP's current Input File submission will be deleted from the COBC’s COBC‟s PAP records. Note: During the course of production data exchange involving current PAP clients this delete process should only be used to remove a record that never should have been sent to CMS, one that should not have been added to our database originally. A beneficiary record that has been correctly added is required to be kept active for the entire period that the Medicare beneficiary continues to be receiving services from the PAP. Periods of "continuous enrollment" may include PAP disenrollment/re-enrollment activity that doesn't result in actual termination from PAP services (for example, periodic automatic reenrollment). Once a Medicare beneficiary's PAP enrollment ends and after the PAP sends CMS an accepted "Termination Date" in a subsequent Input File (see the Input File, Field #8), we do not require the PAP to continue to include that beneficiary's information on later Input Files. However, we recommend that a PAP consider continuing to include former PAP enrollee data on later Input Files for a period of time determined to be of value to the PAP. Previous PAP enrollee data that is omitted from a later Input File will be a "Delete," and will cause all evidence of PAP enrollment to disappear from the beneficiary's record on the CMS database. Because such deleted data cannot be recovered there will no longer be any record of PAP – CMS data sharing at CMS. If a PAP determines there is value in keeping the record of a Medicare beneficiary's PAP activity available on the CMS database, the PAP should continue to include the beneficiary's data on subsequent PAP Input Files. Records containing errors are returned to the PAP with the appropriate error code on the response record linked to the erroneous input data. The PAP should identify and correct the error, and resubmit the record with the next month's regular Input File. When processing of incoming data is complete, a file is created and transmitted to the MBD containing the adds, updates, and delete records generated by the COBC from the Input File submitted by the PAP. The MBD returns a file to the COBC containing Part D enrollment information. Within 15 days of the PAP Input File submission, the COBC generates and transmits a Response File to the PAP. This file contains responses for any records that were added, updated, or deleted. The file does not contain responses for records to which no change was made. The Response File also contains the Part D enrollment information received from the MBD.
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Adds. Using the beneficiary's HICN, the incoming record is compared to the database to attempt to match on previously submitted records. The data elements comprising the set of initial matching criteria consist of the HICN, Effective Date, Insurance Type, and PAP ID. If a match of these fields cannot be made on the existing database, the incoming record is considered an "add." (a new record). If incoming field matches indicate a record is not an Add, additional fields are compared to determine if the incoming record should be considered an update. These fields include Toll-Free Number, Coverage Type, and Termination Date. If any of these fields have changed from the previous month's submission the record is considered an update. If the incoming record matches exactly on these additional fields, no action is taken and the PAP does not receive a response for this record. Any records previously added, but not now included in the PAP's current Input File submission will be are processed as deleted from the COBC’s PAP records. Note: During Note that during the course of production data exchange involving current PAP clients this delete process should only be used to remove a record that never should have been sent to CMS, one that should not have been added to our database originally. A beneficiary record that has been correctly added is required to be kept active for the entire period that the Medicare beneficiary continues to be receiving services from the PAP. Periods of "continuous enrollment" may include PAP disenrollment/re-enrollment activity that doesn't result in actual termination from PAP services (for example, periodic automatic reenrollment). Once a Medicare beneficiary's PAP enrollment ends and after the PAP sends CMS an accepted "Termination Date" in a subsequent Input File (see the Input File, Field #8), we do not require the PAP to continue to include that beneficiary's information on later Input Files. However, we recommend that a PAP consider continuing to include former PAP enrollee data on later Input Files for a period of time determined to be of value to the PAP. Previous PAP enrollee data that is omitted from a later Input File will be a "Delete," and will cause all evidence of PAP enrollment to disappear from the beneficiary's record on the CMS database. Because such deleted data cannot be recovered there will no longer be any record of PAP – CMS data sharing at CMS. If a PAP determines there is value in keeping the record of a Medicare beneficiary's PAP activity available on the CMS database, the PAP should continue to include the beneficiary's data on subsequent PAP Input Files. Records containing errors are returned to the PAP with the appropriate error code on the response record linked to the erroneous input data. The PAP should identify and correct the error, and resubmit the record with the next month's regular Input File. When processing of incoming data is complete, a file is created and transmitted to the MBD containing the adds, updates, and delete records generated by the COBC from the Input File submitted by the PAP. The MBD returns a file to the COBC containing Part D enrollment information. Within 15 days of the PAP Input File submission, the COBC generates and transmits a Response File to the PAP. This file contains responses for any records that were added, updated, or deleted. The file does not contain responses for records to which no change was made. The Response File also contains the Part D enrollment information received from the MBD.
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