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Support: APCD Data Requests
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Issue: Current Age Fields
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Issue: EBD Pharmacy NPI Mapping
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Issue: Inconsistent Member and Subscriber IDs in 12151, 70580, 95885, 73288
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Issue: Incorrect Member ID in 70408
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Issue: ME003 Value for Arkansas Works
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Issue: Member IDs and Subscriber IDs
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Issue: Member/Claim Linkage for 62286A
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Issue: Overall Data Issues for 64246
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Issue: PC043 and PC050 Values/Pharmacy Versioning - Humana Entities
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Issue: Pharmacy Claim Versioning for 79413A & 95446
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Issue: Pharmacy Claim Versioning for 79413C
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Tip: New Use Recommendations for Source of Coverage Fields (ME018, ME019, ME020)
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Issue: Subscriber DOB and Age for 99HSM1
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Issue: United Health Care Student Resources Pharmacy Claim Versioning
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Tip: Medicaid State AID Category and Health Plan definitions
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Issue: 67369B Claim Status data quality
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Tip: Arkansas Medicaid Billing documentation
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Tip: Arkansas Medicaid Member Consolidation
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Tip: Assigning Rural/Urban using ZIP3
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Tip: Cancer data updates
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Tip: Identifying Arkansas PASSE claims
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Tip: Identifying Claims Duplicated across Carriers
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Tip: Identifying Members in Qualified Health Plans and Arkansas Marketplace Exchange Plans
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Tip: Inpatient and Institutional Definition Expansion
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Tip: Medical Claim Out-of-Pocket Cost Calculation
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Tip: Medicare Hospital Claims for Emergency Room Visits
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Tip: New Plans for Ameritas Life Insurance Corp.
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Tip: New plans for Golden Rule Insurance Company
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Tip: Orphaned Claims - 99OPT1 (Optum)
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Tip: Orphaned Dental Claims - 61271
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Issue: Orphaned Medical Claims - 67369
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Tip: Pharmacy Out-of-pocket amounts
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Tip: Reconciled Arkansas Medicaid Pharmacy Claims
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TIP: Resource for Deciphering Service Provider Names
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Tip: Submitting Entity Merge - 60054A, 99CAR1 (PBM)
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Tip: Submitting Entity Merge - 67369, 67369A, 67369B
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Tip: Submitting Entity Merge - 90328, 10155
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Tip: Submitting Entity Merge - 95792 and 10155
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Tip: Submitting Entity Merge - United and Care Improvement
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Tip: Subscriber Information - Arkansas Employee Benefits Division (EBD)
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Tip: Active Medicaid Member Identification
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Tip: Alias Fields
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Tip: APCD Unique ID, aka Hash ID
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Tip: Arkansas Medicaid Policy Manuals
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Tip: Arkansas Medicaid Provider and Plan Resources
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Tip: Arkansas Medicare and Arkansas Medicaid Fee Structures
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Tip: Arkansas Medicare Medical and DME Claim Payment Calculations
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Tip: Calculated Services Indicator Flags (ME018A, ME019A, ME020A)
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Tip: County Name / FIPS Code Transformation
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Tip: Data Coverage
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Tip: DOB/AGE
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Tip: Duplicated Submission in EBD (99EBD1) and Qualchoice (95448B)
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Tip: Finding Birth Year for Arkansas Medicare beneficiaries
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Tip: ICD9 or ICD10 designation
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Tip: ICD Diagnosis and Procedure Codes for 99EBD1
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Tip: Identifying Arkansas Medicaid Members in Health Care Independence Programs (HCIP)
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Tip: Identifying Subscribers
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Issue: Invalid member records in 67369D
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Tip: Masking
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Tip: Medicare Advantage Plans
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Issue: Member/Claim Linkage for 99HSM1
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Tip: Missing Member Date of Birth
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Tip: Multiple Medicaid Member IDs
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Tip: Multiple Records per Individual in Medical Marijuana Data
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Tip: New Service Provider Data for 99EBD1 Medical Claims
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Tip: Optional vs. Required Data Fields
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Issue: Orphan Pharmacy Claims - 67369
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Tip: Orphaned Dental Claims - 60054A
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Tip: Orphaned Medical Claims - 60054A
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Tip: Pharmacy Carrier Overlap
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Tip: Provider Specialty
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Tip: State Code Transformation
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Tip: Submitting Entity Merge - 12231, 79413A
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Tip: Submitting Entity Merge - Centene/Celtic and Qualchoice
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Tip: Unique Member Identification by SE
Tip: USPS ZIP Code Transformation
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Tip: Valid Value Identification
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Tip: Versioning
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Issue: EBD Revenue Code Values
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Tip: EBD Subscriber Data Enhancement
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Issue: Incorrect Open Enrollment Segments
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Tip: How to link enrollment and claims data
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Tip: Multiple Medicare Beneficiary IDs per APCD Unique ID (Study ID)
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Tip: Disenrollment dates = 9999-12-31 or NULL
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Tip: Identifying Medicare Part D Eligible Beneficiaries
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Tip: Joining Medicare Beneficiaries to APCD Members
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Issue: Default dates in Date of Birth or Birth Year
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Tip: Members over age 65
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Tip: Medicare Part D claims
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Tip: Medicare ICD9 and ICD10 code identifiers
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Tip: Medicare Postal Fields
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Tip: Identifying Nurse Practitioner and Physician Assistant Services
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Tip: Disenrollment Dates in the Future - QualChoice
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Tip: Disenrollment Dates in the Future - United Dental
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Tip: Disenrollment Dates in the Future - Cigna
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99EBD1 - Members with No Coverage
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ME040 Value suffix definitions - Aetna
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Issue: Caremark Member IDs with Multiple Dates of Birth/Genders
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Tip: Managing overlap between Medicare fee for service claims and Medicare Advantage Plan claims
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Tip: Low Counts for Sun Life Dental
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Issue: Empower APCD Unique IDs
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Tip: Shared Pharmacy Prescription Numbers
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Tip: Tooth Number Assignment in Dental Claim Records for 67369D
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Tip: EBD Pharmacy Claim Versioning Workaround
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Issue: Lincoln Disenrollment Dates
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Issue: Presence of older, possible invalid data - 12151
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Tip: TPA and PBM Replacement Data for EBD - Original
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Tip: Terminology change - Hash_ID to Study_ID
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Issue: 99HSM1 - Open Segment Disenrollment Date Irregularity
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Tip: 70998A and 95448A - Open Segment Disenrollment Date Irregularity
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Tip: 79413B - Open Segment Disenrollment Date Irregularity
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Tip: 70998C, 80799, 95448C Open Segment Disenrollment Dates
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Tip: 79413C Open Segment Disenrollment Date
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Issue: AETNA Pharmacy Versioning - 90328
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Issue: Cigna Entity Study ID
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Arkansas Medicare Enrollment Data Use Information
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Arkansas Medicare Outpatient Fee-for-Service Information
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Redefined field - ME001_CAT (PAYER_TYPE)
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Tip: Differentiating between Child and Parent records in Birth Data
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Issue: 47155 Open Enrollment Segments 2013-2014
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Tip: TPA and PBM Replacement Data for EBD - REVISED
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Issue: MedImpact Pharmacy Orphans
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Issue: Versioning for MedImpact Entities
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Issue: CareSource PASSE orphans
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Issue: United Health Care (99UHC1) missing enrollment data
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Tip: 95442 - EBD Retirement Plan Name Definitions
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Tip: Claims with Multiple Member Numbers
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Issue: Incorrect Race Code Assignment
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Tip: Using CareMark data
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Issue: Hyphen in ME992
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Tip: New Insurance Product Code - PBM
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Tip: Updated Place of Service/Facility Type Codes
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Tip: New HIOS ID Variant Codes
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Tip: Identifying Administrative Services Enrollment
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Issue: 95442 - ME019 flagged for Dental Plans
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Issue: 9999-12-31 in MC017 or MC059
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ISSUE: Duplicated United Healthcare medical claims
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Tip: Reused Claim Numbers
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Tip: Definition of Fetal Deaths - ADH Birth Certificate Data
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Issue: 69019 Orphaned Dental Claims
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Tip: ICD Procedure Codes in CPT code fields and visa versa
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Issue: 16256 - Missing HIOS ID
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Tip: Updated Mother Smoking Indicator Definition
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Tip: Deduping Pharmacy Enrollment Data and Claims from PBMs
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Issue: Ameritas (61301) Member ID/Study ID Combinations
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Tip: Wellcare (10155) Medicare Advantage Plan Type Identification
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Issue: Incorrect open segments for Caremark (99CAR1)
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Tip: Flagging beneficiaries in D-SNP plans
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Tip: New Arkansas BCBS submitter - 16751
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Issue: Finding missing Pharmacy NPIs
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Tip: Medicare Fee for Service Claims - Paid Date
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Tip: Inpatient claims identification
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