Is the “NUNCMO” Nightmare Keeping You Up at Night?
The recent MAPD Help Desk Memo, dated 3/3/15, advises that on March 8, 2015, “The Centers for Medicare & Medicaid Services (CMS) will be performing a clean-up to process “73” transactions that contain NUNCMO (Number of Uncovered Months) value from the extraneous NUNCMO row that was removed in Phase 1 multi-phase NUNCMO data clean-up which occurred on March 23, 2014. The effective start date of this transaction will be the preceding Part D enrollment start date.”
The memo goes on to say that Part D organizations should review the NUNCMO data for these beneficiaries for ALL time frames, even if the change is prior to 2012. Organizations should submit any changes that may be necessary if the data is inaccurate or incorrect!
Looks like this could be trouble…
If your organization has an automated processes in place to update “73” transactions in your system, and the information on the data file is incorrect, these files could end up being a “nightmare.” Loading incorrect data in your systems can result in significant consequences, such as generation of bills, correspondence, and increased customer service call volume.
Best-case scenario?
Increased customer service call volume.
Worst-case scenario?
Complaint Tracking Module complaints (CTMs) or increased Independent Review Entity (IRE) reconsideration requests if late enrollment penalties are inaccurately retroactively imposed.
How should you respond to this data file once you receive it?
Gorman Health Group (GHG) has developed a roadmap solution to guide you through validating and processing this file.
Contact us today to get started!
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When it comes to financial reconciliation and overall membership data management, you must protect against leakage. Need help staying ahead of the CMS reconciliation process? GHG will access your member premium revenue, accounts receivable and CMS revenue reconciliation. Visit our website to learn more >>
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