Issue: MedImpact Pharmacy Orphans

0140

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

Oct 10, 2023

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

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

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

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

Active

Data Quality

Member to Claim Linkage

Issue