Common use of Monthly File Clause in Contracts

Monthly File. The Department will provide a Monthly Participant File to the CHC-MCO on the next to the last Saturday of each month. The file contains the MA Eligibility Period, CHC-MCO coverage, BH-MCO coverage, and other Participant demographic information. It will contain only one record for each CHC Participant (the most current) where the Participant is both MA and CHC eligible at some point in the following month. The CHC-MCO must reconcile this Participant file against its internal Participant information and notify the Department of any discrepancies found within the data on the file within thirty (30) business days. The CHC-MCO is not responsible for Participants not included on this file with an indication of prospective coverage unless a subsequent Daily Participant Enrollment File indicates otherwise. The CHC-MCO is not responsible for Participants with an indication of future month coverage if the Daily Participant Enrollment File received by the CHC-MCO prior to the beginning of the future month indicates otherwise.

Monthly File. The Department will provide a Monthly Participant File to for the CHC-MCO on the next to the last Saturday of each month. The file contains the MA Eligibility Period, CHC-MCO coverage, BH-MCO coverage, coverage and other Participant demographic information. It will contain only one record for each CHC Participant (the most current) where the Participant is both MA and CHC eligible at some point in the following month. The CHC-MCO must reconcile this Participant file against its internal Participant information and notify the Department of any discrepancies found within the data on the file within thirty (30) business days. The CHC-MCO is not responsible for Participants not included on this file with an indication of prospective coverage unless a subsequent Daily Participant Enrollment File indicates otherwise. The CHC-MCO is not responsible for Participants with an indication of future month coverage if the an 834 Daily Participant Enrollment File received by the CHC-MCO prior to the beginning of the future month indicates otherwise.

Monthly File. The Department will provide a Monthly Participant 834 Eligibility File to the CHC-MCO on the next to the last Saturday of each month. The file contains the MA Eligibility Period, CHC-MCO coverage, BH-MCO coverage, and other Participant demographic information. It will contain only one the most current record for each CHC Participant (the most current) where the Participant is both MA and CHC eligible at some point in the following month. The CHC-MCO must reconcile this Participant file against its internal Participant information data and notify the Department of any discrepancies found within the data on the file within thirty (30) business days. The CHC-MCO is not responsible for Participants not included on this file with an indication of prospective coverage unless a subsequent Daily Participant Enrollment 834 Eligibility File indicates otherwise. The CHC-MCO is not responsible for Participants with an indication of future month coverage if the Daily Participant Enrollment 834 Eligibility File received by the CHC-MCO prior to the beginning of the future month indicates otherwise.