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emedny HIPAA Support > 834 Frequently Asked Questions

Frequently Asked Questions (FAQs) for 834 Transactions


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Q.

Will the new eMedNY 834 be posted on the same SFTP server as the NYSoH 834? Will we have to get it from a different folder path?

 

 

Published: 11/7/2019

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Updated: 11/7/2019

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QID: L2

 
 

A.

No, the NYSOH 834 and the eMedNY 834 are different files; the eMedNY version will only be available via eMedNY access methods. Please refer to section 4.2 of the Managed Care Enrollment (MCE) 834 Companion Guide on emedny.org under the eMedNY HIPAA Support tab for details.

 
 

Q.

Where will the eMedNY 834 Client Enrollment file be delivered?

 

 

Published: 11/7/2019

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Updated: 11/7/2019

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QID: L3

 
 

Q.

Will the first file after go-live be an audit file?

 

 

Published: 11/25/2019

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Updated: 11/25/2019

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QID: L4

 
 

Q.

For support questions after go-live, who is the contact?

 

 

Published: 11/25/2019

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Updated: 11/25/2019

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QID: L5

 
 

Q.

Please advise the status of the various Maximus NYMC files (A, E, L, T, DU, Homeless etc.). What files will we continue to receive, and which will be discontinued?

 

 

Published: 12/10/2019

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Updated: 12/10/2019

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QID: L6

 
 

Q.

Does eMedNY/DOH expect to receive effectuations from Plans?

 

 

Published: 11/1/2019

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Updated: 11/1/2019

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QID: L8

 
 

Q.

Will there be any sort of error reporting for effectuations that are rejected by DOH? If so, what type of report will it be and how frequently will it be received?

 

 

Published: 11/1/2019

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Updated: 11/1/2019

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QID: L9

 
 

Q.

Will issuers be required to perform any sort of enrollment reconciliation with DOH?

 

 

Published: 11/25/2019

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Updated: 11/25/2019

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QID: L11

 
 

Q.

Will the submission of effectuations drive capitation payments?

 

 

Published: 11/1/2019

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Updated: 11/1/2019

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QID: L12

 
 

Q.

What is the QHP Policy ID referenced in 2000 REF - Member Supplemental Identifier noted in the 834 MCE Companion Guide, and does the value need to be stored within our system?

 

 

Published: 12/10/2019

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Updated: 12/10/2019

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QID: L13

 
 

Q.

If we have several different products (HARP, PACE etc.) will we receive one file?

 

 

Published: 11/1/2019

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Updated: 11/1/2019

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QID: L14

 
 

Q.

When the process is transitioned to the 834 format will clients be assigned new CIN numbers?

 

 

Published: 11/1/2019

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Updated: 11/1/2019

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QID: L20

 
 

Q.

How many RRE codes should we expect to receive?

 

 

Published: 11/7/2019

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Updated: 11/7/2019

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QID: L21

 
 

Q.

Will the 025 maintenance type transaction (reinstatement/re-enrollment) be sent on the 834 file? The companion guide only referenced 001, 021, 024 and 030 maintenance type transactions.

 

 

Published: 11/7/2019

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Updated: 11/7/2019

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QID: L24

 
 

Q.

Which date should the Plan use as the Plan enrollment date, 348 Benefit Begin Date or 356 Plan Eligibility Begin Date?

 

 

Published: 11/7/2019

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Updated: 11/7/2019

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QID: L25

 
 

Q.

Which date should the Plan use as the Plan disenrollment date, 349 Benefit End Date or 357 Plan Eligibility End Date?

 

 

Published: 11/7/2019

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Updated: 11/7/2019

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QID: L26

 
 

Q.

Will the Primary Care Physician be provided on the 834-enrollment file?

 

 

Published: 11/7/2019

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Updated: 11/7/2019

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QID: L27

 
 

Q.

Will the Expected Date of Confinement (EDC - Due Date) be provided on the 834-enrollment file?

 

 

Published: 11/7/2019

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Updated: 11/7/2019

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QID: L29

 
 

Q.

What would be the source of truth, eMedNY or the 834-enrollment file?

 

 

Published: 11/7/2019

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Updated: 11/7/2019

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QID: L32

 
 

Q.

Will the Health Commerce System (HCS) site still be used for any roster files?

 

 

Published: 11/25/2019

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Updated: 11/25/2019

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QID: L47

 
 

Q.

Will the recert date for the upstate counties be included on the 834?

 

 

Published: 12/10/2019

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Updated: 12/10/2019

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QID: L49

 
 

Q.

Will there be a monthly correction file?

 

 

Published: 11/25/2019

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Updated: 11/25/2019

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QID: L54

 
 

Q.

How will unborns/newborns be sent in the 834?

 

 

Published: 12/10/2019

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Updated: 12/10/2019

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QID: L57

 
 

Q.

Third Party Liability Coverage - will this be populated?

 

 

Published: 11/25/2019

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Updated: 11/25/2019

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QID: L58