Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.
Page Properties

Number

0140

Submitting Entity (SE)

99MDI1, 99MDI2, 99MDI3, 99MDI4, 99MDI5

Add Date

Update Date

Update

Description

99MDI4 and 99MDI5:

Member IDs (PC107) and Subscriber ID (PC108) on MedImpact pharmacy claims for 99MDI4 and 99MDI5 where paid date (PC017) >= 2023-01-01 are incorrectly formatted. The MedImpact ID length should be 8 characters. The IDs present on the pharmacy claims in this date range are 10 characters - the last 2 characters were incorrectly appended.

Workaround: Use the first 8 bytes of the member ID for these claims

Code Block
substring(PC107,1,8)
substring(PC108,1,8)

This issue will be resolved in the next APCD release.

99MDI1, 99MDI2, 99MDI3

Member IDs (ME107) and Subscriber IDs (ME117) on MedImpact member data and Member IDs (PC107) and Subscriber IDs (PC108) on MedImpact Pharmacy claims ( for 99MDI1, 99MDI2 and 99MDI3) have formatting issues. These data will be resubmitted once resolution has been found. These issues create orphaned claims.

99MDI1 - approximately 18% 4% of member records pharmacy claims do not match pharmacy claims member data on member ID therefore orphaned pharmacy claims exist. Issues exist with both the member and subscriber IDs (PC107 and PC108).

99MDI2 - approximately 30% 56% of member records pharmacy claims do not match pharmacy claims member data on member ID therefore orphaned pharmacy claims exist. Issues exist with both the member and subscriber IDs (PC107 and PC108).

99MDI3 - approximately 50% 7% of member records pharmacy claims do not match pharmacy claims member data on member ID therefore orphaned pharmacy claims exist. Issues exist with both the member and subscriber IDs (PC107 and PC108).

Active/Resolved

Active

Action / Resolution

Category 1

Data Quality

Category 2

Member to Claim Linkage

Tip / Issue

Issue

Grouping FieldsĀ