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Page Properties


Number

0045

Submitting Entity (SE)

99EBD1

Add Date

Update Date

Update

Updated description.

Description

HMO Partners, Inc. (Arkansas BlueCross and BlueShield) (SE 95442) serves as TPA for the Arkansas Employee Benefits Division (SE 99EBD1) and is testing submission of data for SE 99EBD1 creating duplicate member records.

Active/Resolved

Active

Resolved

Action / Resolution

With the replacement of EBD data with TPA data, this tip is no longer required. TPA and PBM Replacement Data for EBD for data from APCD update 22D forward.

It is advised that data users omit all member records from SE 95442 (HealthAdvantage) where the value in the Employer Name field (ME082) begins with ASE or PSE. 

Find the SE 95442 member records related to the SE 99EBD1 member records by grouping on

Hash

Study ID (created by concatenating APCD Unique ID (ME998) and member gender (ME013)). Drop the SE 95442

records. is advised that data users omit all member

records

from submitting entity (ME001 = 95442)

where

the value in

the Employer Name field (ME082) begins with ASE

or

and PSE.

  These data will be replaced in a later build. 

NOTE:  A similar situation exists for SE 95448B however it is not the same issue.

This prxmatch SAS function could be helpful: prxmatch("/(A|P)SE[^A]/i",ME032_GroupName) =1

Category 1

Merged SE & Overlap

Category 2

TPA

Tip / Issue

Issue