Tip: 70998C/95448C Intersection in Pharmacy Data

Number

0081

Submitting Entity (SE)

70998C, 95448C

Add Date

Apr 29, 2021

Update Date

May 17, 2022 May 24, 2023

Update

Included in June 2023 monthly email.

Description

Centene (70998C, 95448C) has acquired several plans from QC (70998A, 95448A). Because these plan management is now with Centene, the claims will now be sourced from a new system, triggering the need to use the Alias ID fields.

Changed from Issue to Tip

Active/Resolved

Active

Action / Resolution

The member ID in Pharmacy data cannot be used to link members between older QC plans and the new Centene managed plans. Data users can follow these workaround options:

  • Use the member ID in 70998C/95448C PHM to get the member ID 70998C/95448C ELG and use the Study ID (ME998+ME013) to link across submitters.

  • Use the member ID in 70998C/95448C PHM to get the member ID in 70998C/95448C ELG and use the Alias fields in ELG (ME107A/ME117A) to find the member ID in QC (70998A/95448A)

Category 1

Alias Fields

Category 2

Acquisition

Tip / Issue

Tip