State and MMP User Guides for MMP Enrollment Processing

Author: 
Infocrossing
Published: 
September 2020

Medicare-Medicaid Plan (MMP) Technical Guide to Eligibility and Enrollment Transaction Processing

This guide describes the interface that states with Financial Alignment Initiative Demonstrations use to conduct Medicare eligibility verification and MMP enrollment submission to the CMS MARx systems. Version 3.3 of the Guide reflects the CMS October 2020 software changes as documented in the HPMS Software release announcements on August 25, 2020 and September 1, 2020.

The changes include modifying the enrollment transaction code 61 to account for two new optional fields:

  • Preferred Language other than English (Spanish or Other)
  • Accessible Format (Braille, Large Print, or Audio CD)

In addition, two new batch transactions codes will be generated on the Infocrossing batch response file when invalid values are found for these new field additions (“2C” for the new optional “Preferred Language Other than English” field and “3C” for the “Accessible Format” field). Finally, the prohibition of MMP enrollment for beneficiaries with ESRD has been removed, effective January 1, 2021.

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Infocrossing E&E360 Online Interface State & MMP User Guide

This user guide, produced in September 2019, provides detailed instructions for state and MMP users on the new Infocrossing online interface that states and MMPs use to submit eligibility queries and enrollment transactions for Financial Alignment Initiative demonstrations. The instructions include screen shots to help users successfully navigate the new interface. This user guide, produced in September 2019, provides detailed instructions for state and MMP users on the new Infocrossing online interface that states and MMPs use to submit eligibility queries and enrollment transactions for Financial Alignment Initiative demonstrations. The instructions include screen shots to help users successfully navigate the new interface.

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