Common use of Eligibility and Enrollment Data Exchange Requirements Clause in Contracts

Eligibility and Enrollment Data Exchange Requirements. a. The Health Plan shall receive, process and update enrollment files sent daily by the Agency or its agent. b. The Health Plan shall update its eligibility/enrollment databases within twenty-four (24) hours after receipt of said files. c. The Health Plan shall transmit to the Agency or its agent, in a periodicity schedule, format and data exchange method to be determined by the Agency, specific data it may ▇▇▇▇▇▇ from an enrollee including third party liability data. d. The Health Plan shall be capable of uniquely identifying a distinct Medicaid recipient across multiple systems within its span of control. AMERIGROUP Florida, Inc. d/b/a Medicaid Non-Reform and Reform AMERIGROUP Community Care HMO Contract

Eligibility and Enrollment Data Exchange Requirements. a. The Health Plan shall receive, process and update enrollment files sent daily by the Agency or its agent. b. The Health Plan shall update its eligibility/enrollment databases within twenty-four (24) hours after receipt of said files. c. The Health Plan shall transmit to the Agency or its agent, in a periodicity schedule, format and data exchange method to be determined by the Agency, specific data it may ▇▇▇▇▇▇ from an enrollee including third party liability data. d. The Health Plan shall be capable of uniquely identifying a distinct Medicaid recipient across multiple systems within its span of control. AMERIGROUP WellCare of Florida, Inc. d/b/a Staywell Health Plan of Florida Medicaid HMO Non-Reform and Reform AMERIGROUP Community Care HMO Contract 1. Availability of Critical Systems Functions