FAQ: How can we submit enrollment changes if we do not have an efficient way to identify and manage enrollment changes month by month?

You may do full enrollment file replacements each month so that you don’t have to track or manage changes. Members that have no change in enrollment (same original start date, no end date) and the same product can be submitted month after month as part of a full file replacement. When a member is no longer enrolled in your plan, you would submit a record indicating the enrollment end date. When a member changes product, you would submit the end of one enrollment and the start of another (two different records/rows).
Creation date: 5/17/2023 9:51 AM      Updated: 12/18/2023 8:48 AM