Tip: Orphaned Medical Claims - 60054A

Number	0073
Submitting Entity (SE)	60054
Add Date	Feb 19, 2021
Update Date	May 18, 2023 Feb 21, 2025
Update	Included in June 2023 data tips email
Description	Orphaned medical claims exist because the leading zeros in person code (ME010, MC009) that Aetna uses to construct the member ID are not present. For example, MC137 = ‘2115075451’ and ME107 = ‘211507545001’. Use this join A.MC141 = B.ME117 and A.MC009 = B.ME010 and A.MC001 = B.ME001 to resolve most orphans.
Active/Resolved	Active (reactivated as orphans showed up again)
Action / Resolution	Ongoing - no resolution
Category 1	Orphaned claims
Category 2	Data Quality
Tip / Issue	Tip

Support: APCD Data Requests