MEDS Reconciliation

1. MEDS Reconciliation CMS Net User Group Meeting March 1, 2006 Brenda Washington

2. Meds Recon Topics • Overview • Affected CMS Net Fields • Working with the Recon

3. Overview • Implemented in October 2005 • Updates CMS Net monthly with data from the MEDS system • Enables providers to view authorizations in the Provider Inquiry Project (PIP)

4. Affected CMS Net Fields • Medi-Cal Coverage • Insurance Other Coverage • Healthy Families Coverage • Patient Registration Face Sheet - SSN

5. Working with the Recon • Duplicate HF / Insurance Coverage • Matches on Carrier Code and Start Date. End date one of the duplicates and make sure CMS Net Start Dates match MEDS. • Medi-Cal Number Blank • Some Aid Codes are not counted as Medi-Cal when determining Caseload Counts. (58,69,71, 74,7K,8X,8Y,9A,9G,9H,9J,9K,9M,9N,9R,9U,IE,RR,0C)

6. Working with the Recon • MEDS has active coverage, but CMS Net does not • Recon pulls data once a month, so any updates will not appear until after the first of each month. • MEDS updates historical information. The Recon is working. Check Last Updated date in MEDS. • Run MEDS Inquiry if data cannot wait!

7. Working with the Recon • Narratives • The Recon will add a narrative to each case it changes. The narrative will only list those CMS Net fields that were changed. • MEDS Inquiry Display • Check the MEDS Inquiry Display on the Event Tracking menu to view historical MEDS Recon information.

8. Working with the Recon • Reviewing Changed Cases • Management Report: MR MEDS Reconciliation • Select County or Regional Office • Specify Date Range to see all cases modified by the MEDS Recon between the two dates

9. MEDS Reconciliation • Questions?