High Hi all:
Can we build a custom edi file to handle unique split coverage logic?
It keeps terming the dependent.
Please look at:
• Geraldine Johnson (spouse of Worth Dikeman) BS200/Express Scripts
• Lorraine Halvorson (spouse of Thomas Halvorson) BS200/Express Scripts
• Rebecca Lambert (spouse of Orvin Lambert) BS200/Express Scripts
• Leslie Ragan (spouse of Steven Ragan) BS200/Express Scripts
• Jennie Jones (spouse of Terry Fleck) BS2000
Here is what Tara from Blue Shield sen a couple months back:
The reason the spouse was termed is because the subscriber is showing as termed. This is, unfortunately, the issue that we are facing with the split contract issue. We need to make sure that we are on the same page on how these members should be coming over. The most recent file has Lorraine attached to a different family unit because she is coming over coded as a dependent only with no subscriber. I have sent this over to our I&B team to see if this is something they can get updated for us.
| Field | Original Value | New Value |
|---|---|---|
| Summary | El dorado: EDI file for Blue shield | El dorado: EDI file for Blue shield And express scripts |
| Assignee | Satya [ ID10004 ] | Rohan Khandave [ rohan.khandave ] |
Hello Ganesh,
Please check El Dorado Blue_Shield_Facets_834_5010_v1 and HSA group template.
Please check policy no and other details of employee & spouse which are exported on file are proper or not?
| Assignee | Rohan Khandave [ rohan.khandave ] | Ganesh Sadawarte [ ganesh.sadawarte ] |
sam lindberg Can we have call on Tuesday PST to discuss this? Please join our EDI meeting on Tuesday to go over this. The meeting is scheduled at 9.30am PST.
Hi:
Please call me at 847-913-6285. You like we can facetime to save money on telecom.
Thank you,
Sam
| Priority | Medium [ 3 ] | High [ 2 ] |
sam lindberg Can you please talk with Cindy Wibbing on this. Cindy got the updates on this which we discussed in our Monday meeting.
| Assignee | Ganesh Sadawarte [ ganesh.sadawarte ] | sam lindberg [ sam.lindberg@ebsbenefits.com ] |
Cindy and chris are handling this. I will assign to chris.
| Assignee | sam lindberg [ sam.lindberg@ebsbenefits.com ] | Chris Ellenberger [ chris.ellenberger ] |
| Module | Parent values: BenAdmin(10100)Level 1 values: Enrollment(10107) | Parent values: BenAdmin(10100)Level 1 values: Export(10110) |
| Issue Importance | Must Have [ 11800 ] |
| Status | Open [ 1 ] | In Progress [ 3 ] |
| Status | In Progress [ 3 ] | Open [ 1 ] |
| Resolution | Fixed [ 1 ] | |
| Status | Open [ 1 ] | Resolved [ 5 ] |
| Status | Resolved [ 5 ] | Closed [ 6 ] |
| Component/s | ACA [ 10004 ] | |
| Component/s | Exchange [ 10003 ] |
| Transition | Time In Source Status | Execution Times |
|---|
|
25d 20h 32m | 1 |
|
2s | 1 |
|
3s | 1 |
|
4s | 1 |
Hi Rohan,
Can you please check this?
Thanks & Regards,
Satya Prakash