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Number

0098

Submitting Entity (SE)

12231, 12567, 90328

Add Date

Update Date

Update

Incorrect disenrollment dates for 12567 have been corrected.

Incorrect disenrollment dates for 90328 have been corrected.

Description

Carriers with incorrect open segments

Active/Resolved

ActiveResolved

Action / Resolution

Incorrect disenrollment dates have been found for the following entities. Resolution in progress. Workarounds described below:

12231 - River Valley moved to United A (79413A) in 2017.  However, River Valley disenrollment dates (ME163A) were not closed properly resulting in a significant number of open enrollment segments.  When the disenrollment date value is 9999-12-31, data users can assume disenrollment of 2016-12-31. RESOLUTION IN PLACE. Corrected data was resubmitted.

90328- First Health/Aetna stopped submitting eligibility data in 2019. Disenrollment dates (ME163A) were not closed properly resulting in a significant number of open enrollment segments.  When the disenrollment date value is 9999-12-31, data users can assume disenrollment of 2018-12-31. RESOLUTION IN PLACE. Corrected data was resubmitted.

12567 - Care Improvement moved to United Health (79413D) in 2017.  However, Care Improvement disenrollment dates (ME163A) were not closed properly resulting in a significant number of open enrollment segments.  When the disenrollment date value is 2199-12-31, data users can assume disenrollment of 2016-12-31.UPDATE: This issue has been corrected for 12567 - Care Improvement. All segments ????

RESOLUTION IN PLACE. Corrected data was resubmitted.

Category 1

Data Quality

Category 2

Enrollment Segments

Tip / Issue

Issue