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Back  RFI # 1122: 834 2100A/N3 Situational Rule

Formal vs. Informal Help Informal Formal

Submitter

Sandi Walsh

Description

The situational rule for the 834 2100A N3 MEMBER RESIDENCE STREET ADDRESS segment appears to have been changed for 5010 to indicate that the street address should only be populated for an 'Update' when the member's street address has changed. The N3 segment would not be sent on an 'Update' transaction when the member's street address had not changed.

Current MMIS processing populates the N3 Member Street Address on each 834 transaction. In order to track changes to the street address, changes would be needed to the MMIS recipient processing to 'flag' the address as a change from what was previously reported to the health plan. This effort would be fairly extensive, as current changes to the MMIS do not involve modification to member enrollment processing.

Could you please clarify the situational rule, and provide guidance on the intent and benefit for only reporting Member Address for address changes when creating an 834 Update transaction.

Submitter Assigned Keywords

834 2100A N3 MEMBER RESIDENCE STREET ADDRESS

Response

This issue is explicitly addressed in guide 005010X220. The situational rule on the 2100A loop N3 segment reads "Required when enrolling subscribers, dependents with different address information, or when changing a member’s address. If not required by this implementation guide, do not send."

Therefore, for an update 834, the address can only be reported when it has changed. The intent as stated in the rule is to not send an address when the address has not changed.

Recommendation

Submission 8/5/2010
Status Date 11/19/2010
Status F - Final
Primary References
Document 005010X220
Section2100A
Page68
Set IDN3
Loop2100A
Segment IDN3