Issue: Orphan Pharmacy Claims - 67369
- Kenley Money
- Kathleen Hart (Unlicensed)
Number | 0070 |
|---|---|
Submitting Entity (SE) | 67369 |
Add Date | Feb 19, 2021 |
Update Date | Jul 14, 2023 Aug 7, 2024 |
Update | Included in July 2023 Data Tips Email. Updated and included in August 2024 email. |
Description | 67369 has orphaned pharmacy claims. Some member IDs in member data have trailing zeros. Use the following suggested code to join 67369 pharmacy and member: PC001 = ME001 and (PC107 = left(ME107,10) or PC107 = ME107). This occurs in years 2018 forward with over 90% of the orphaned claims occurring between October 2021 and March 2023. Note, orphaned medical claims have been resolved -Issue: Orphaned Medical Claims - 67369 There is no resolution for orphaned pharmacy claims. |
Active/Resolved | Active |
Action / Resolution | This will not be resolved. |
Category 1 | Orphaned Claims |
Category 2 | Data Quality |
Tip / Issue | Issue |