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  1. WORKTERRA
  2. WT-2001

El dorado: EDI file for Blue shield And express scripts

    Details

    • Type: Support Activity
    • Status: Closed
    • Priority: High
    • Resolution: Done
    • Affects Version/s: None
    • Fix Version/s: None
    • Component/s: ACA, BenAdmin
    • Labels:
      None
    • Support Task Type:
      Configuration
    • Reported by:
      Support
    • Company:
      El Dorado
    • Module:
      BenAdmin - Export
    • Issue Importance:
      Must Have

      Description

      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.

        Attachments

          Activity

            People

            Assignee:
            Chris.ellenberger Chris Ellenberger
            Reporter:
            sam.lindberg@ebsbenefits.com sam lindberg (Inactive)
            Account Executive:
            sam lindberg (Inactive)
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            0 Vote for this issue
            Watchers:
            5 Start watching this issue

              Dates

              Created:
              Updated:
              Resolved: