Our membership eligibility data is based on a start and end month. Can we report it in that manner?
No. The eligibility data is submitted in a monthly format with one record for each covered life eligible for one or more days of services during the reported month. Each eligibility record in a given month’s file will represent one active member with all reported data elements representing either the status as of the end of the reporting month or as of the premium billing date. For required historical data feeds, carriers must submit one record per member per month of active coverage for the defined historical period. For the historical data, we require that each month of eligibility data be submitted in a separate monthly file.
