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SE_ID | Submitting Entity | Release Notes | Release Status |
16244 | Empower Healthcare Solutions, LLC (MCD PASSE) | Original status: Issues have been identified with the APCD Unique ID (ME998) on the member data therefore data for this submitting entity will not be available for selection. The Arkansas APCD team is working with the submitting entity on data correction and resubmission.
Updated status: Issue has been resolved and data resubmitted.
| Included |
47155 | Delta Dental | An internal system change at Delta Dental resulted in a data submission gap in which updated records were not received when an enrollment segment closed.
Replacement data has been received and applied to years 2015 forward, correcting disenrollment dates (ME163A) to close segments appropriately.
NOTE: Years 2013 and 2014 are still problematic and cannot be corrected. This workaround is suggested: Pull the available claims for members and assess the latest paid date to understand when the members were last active. Determine if the time since the last paid date represents what could be an inactive member.
Updated status: Segments are still being received as open that should be closed. Use with caution until final resolution is in place. The referenced data tip provides suggested workaround.
See Data Tip 0080. | Included.
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99EBD1 | Employee Benefits Division | A pharmacy claim versioning workaround is available. The methodology requires grouping by script number, pharmacy number, fill date, and drug code, not claim line.
See Data Tip 0121. | Included |
99MCD1 | Arkansas Medicaid | New flags have been added in this update to identify PASSE claims submitted by Arkansas Medicaid.
The Provider-led Arkansas Shared Savings Entity (PASSE) – a new model of organized care created by Arkansas Act 775 – addresses the total health care needs of Medicaid beneficiaries who have behavioral health (BH) disorders or intellectual developmental disabilities (IDD). The purpose of the model is to improve the health of those who need intensive levels of specialized care, link providers of physical health care with specialty BH and IDD providers and coordinate care for all community-based services.
PASSE third party administrators (TPA) submit claims for the services provided to qualifying Arkansas Medicaid beneficiaries. Arkansas Medicaid also submits these claims as part of the Arkansas Medicaid data provided to the Arkansas APCD. The Arkansas Medicaid PASSE claims should NOT be used. They do not contain usable data for these services.
To identify PASSE claims, Arkansas Medicaid provides a supplemental file containing all PASSE claim numbers. The HTI team joins these data to the Arkansas Medicaid claims. When a match occurs, the PASSE flag is set on medical (MC841), pharmacy (PC841), or dental (DC841) claims.
Going forward, fulfilled data requests will contain the private carrier version of the PASSE claim, not the Arkansas Medicaid PASSE claim.
Arkansas Medicaid PASS claims are available upon request.
To identify and manage PASSE claims in older Arkansas APCD data, refer to Data Tip 0047.
| Informational |
99MCD1 | Arkansas Medicaid | All dental claims from January 1, 2013 through March 2022 were resubmitted to correct an issue with DC030 - Facility Type. This field was previously coded with a single placeholder value. Arkansas Medicaid facility type codes are now present. | Informational |
12567 | Care Improvement | Incorrect disenrollment dates were identified for this submitting entity. The disenrollment dates have been corrected.
See Data Tip 0098. | Included |
90328 | First Health/Aetna | Incorrect disenrollment dates were identified for this submitting entity. The disenrollment dates have been corrected.
See Data Tip 0098. | Included |
60054M | AETNA Life Insurance Company-Traditional | Values in ME003, MC003, PC003, DC003 for plans/claims associated with AETNA’s Medicare Risk/Part C plans were incorrect. The incorrect value, ‘HM’, has been transformed to the correct value, ‘HN’ on the appropriate enrollment and claims data. | Included |
65676 | Lincoln | Issues were discovered with disenrollment dates for Lincoln. Lincoln data is not included in the 22C database. | Not included |
83470, 95442 | Arkansas BlueCross BlueShield | This submitting entity is transitioning to a new dental claim processing system. Issues exist with newer data pulls. The only dental claim data available is through December 2021. Resolution is in development. | Included |
12331 | United River Valley | Incorrect disenrollment dates were identified for this submitting entity. The disenrollment dates have been corrected.
See Data Tip 0098. | Included |
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Data Element Number | Data Element Name | Description | |
ME021, ME022 | Member Race 1, Member Race 2 | These fields were originally optional. Submitting entities are now required to submit them. | |
ME025, ME026 | Member Ethnicity 1, Member Ethnicity 2 | These fields were originally optional. Submitting entities are now required to submit them. | |
ME033, ME157A | Member Language, Subscriber Language | These fields were originally optional. Submitting entities are now required to submit them. | |
ME154A, ME155A | Subscriber Race 1, Subscriber Race 2 | These fields were originally optional. Submitting entities are now required to submit them. | |
ME156A, ME166A | Subscriber Ethnicity 1, Subscriber Ethnicity 2 | These fields were originally optional. Submitting entities are now required to submit them. | |
ME040 | Member Product Code | This change applies to Arkansas Medicaid. This field now contains Federal Medicaid AID Category codes. State AID Category codes are now in ME910. | ME023. |
ME112 | Referring National Provider ID | These fields were originally optional. Submitting entities are now required to submit them. | |
ME122 | Grandfather Status | New data element values added. | |
MC023 | Final Discharge Status | This field is now populated for Institutional claims as well as inpatient claims. | |
MC039 | Admitting Diagnosis | This field is now populated for Institutional claims as well as inpatient claims. | |
MC058-MC058L | ICD Procedure Codes | This field is now populated for Institutional claims as well as inpatient claims. | |
MC092 | Covered Days | This field is now populated for Institutional claims as well as inpatient claims. | |
MC154-MC166 | Present on Admission Codes | This field is now populated for Institutional claims as well as inpatient claims. |
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