Tip: Arkansas Medicaid Member Consolidation

0092

99MCD1

Sep 14, 2021

Nov 8, 2022

included in Nov 2022 data tip email and Feb 2024 data tip email

High pharmacy paid claim count in December 2020.

Active

Arkansas Medicaid members can have multiple member IDs generated over time as members move from one Medicaid program to another.  For example, if John Doe is issued different Medicaid numbers by two different offices, he may have claims that are paid under both numbers. Eventually, the Arkansas Medicaid MMIS system recognizes that these different numbers are assigned to the same person and “links” them together under a new single member id.  When this happens, the MMIS generates replacement claim records to supersede the records that were submitted under the old id.  These replacement claim numbers will all begin with digits ‘49’.

The additional claims included in the December 2020 submission are link-adjusted claims from MMIS that have never been submitted to the APCD before.  These claims were processed through the Arkansas APCD Medicaid data versioning process to ensure that the original existing claims were replaced correctly by these new claims.  The data user should not encounter issues because of these replacement claims.

Medicaid

Data Quality

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