1 / 15

MARx RM Technical Overview Presented by: Jack Fletcher, MARx RM Team Lead 7 September 2010

faraji
Download Presentation

MARx RM Technical Overview Presented by: Jack Fletcher, MARx RM Team Lead 7 September 2010

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. MARx R&M Technical Overview Presented by: Jack Fletcher, MARx R&M Team Lead 7 September 2010 MAY CONTAIN INFORMATION THAT IS NOT RELEASABLE TO THE PUBLIC UNLESS AUTHORIZED BY LAW: This information has not been publicly disclosed and may be privileged and confidential. It is for internal government use only and must not be disseminated, distributed, or copied to persons not authorized to receive the information. Unauthorized disclosure may result in prosecution to the full extent of the law.

    2. MARx R&M – Technical Overview Team introduction Changes to MARx affecting Plans New features in MARx for Plans What’s next for Plans 2

    3. MARx R&M - Team 3

    4. MARx R&M – Daily TRR One-day turnaround responses to plans All plans will receive a daily TRR Return records submitted and processed TRC responses to submitted transactions, including UI updates TRC for other transactions impacting plan TRC for no information to report 4

    5. MARx R&M – Daily TRR Draft TRR Record Layouts New Record Response Format New TRR Record Format – TRC sensitive New “No Data to Report” Format 5

    6. MARx R&M – Transaction Changes Split 74 transaction into distinct types New 76 - Beneficiary residence address New 80 & 81 – Cancel enrollment/ disenrollment 6

    7. MARx R&M – Split 74 Transaction 72 – 4RX update 73 – NUNCMO update 74 – EGHP Flag update 75 – Premium Withhold Option change 77 – Segment ID change 78 – Part C Premium amount change 79 – Beneficiary Opt Out change 7

    8. MARx R&M – 76-Beneficiary Address New transaction supporting beneficiary residence address Not intended for every enrollment Only needed for Out of Service Area Replaces need for State/County Code support from RPC Does not replace SSA Bene Address 8 Note that 76 is intended for those cases when the SSA mailing address is not in the plan’s service area. (Similar to current instructions, handled as casework via MBD UI). CMS does not want to create a repository of residence addresses. Note that 76 is intended for those cases when the SSA mailing address is not in the plan’s service area. (Similar to current instructions, handled as casework via MBD UI). CMS does not want to create a repository of residence addresses.

    9. MARx R&M – 76–Beneficiary Address New transaction record layout New TRCs 9

    10. MARx R&M – 80&81-Cancel Transactions Cancel enrollments and disenrollments Must match submitted enrollment or disenrollment Will result in reinstating beneficiary back to previous condition Will apply time sequence processing Supported in batch and online 10

    11. MARx R&M – NUNCMO Auto-Reset Automatic MARx NUNCMO zero-reset for beneficiaries turning 65 Eliminate need for plan-submitted reset for second IEP New MARx-generated TRC for auto NUNCMO zero-reset sent to affected Plans 11

    12. MARx R&M – New Plan UI Update Plans will have limited UI update capability Supports Plan changes to enrollment and other Plan responsible data Two (2) update users per Plan Same standard policy limitations 12

    13. MARx R&M – New Plan UI Update Sample screen shots Does not replace batch processing CMS will actively monitor usage Plan misuse will not be tolerated 13

    14. MARx R&M – New Plan UI Update Online supported transactions Enrollment Disenrollment 4Rx, NUNCMO, PPO, EGHP Flag, Segment ID, Part C Premium, Part D Opt Out Beneficiary Residence Address Cancel Enrollment/Disenrollment 14

    15. MARx R&M – What’s Next MARx R&M Handbook late October Plan-oriented guidance for processing New transactions, record layouts, TRCs Plan Testing for Daily TRR Push file from CMS available to all Plans PCUG in mid-January Final specifications 15

    16. MARx R&M - Questions 16

More Related