Schedule P TRR Report Template.xlsx

XLSX spreadsheet 17 KB Posted

Attached to
HMO Services for MPSERS
Solicitation number
RFP 171 230000003226 2
Issued by
Michigan

About this file

This is a Schedule P Transaction Reply Report (TRR) template document associated with RFP No. 230000003226, designed for processing Medicare enrollment and benefits data submissions. The template establishes a standardized data collection format for reporting beneficiary information, enrollment transactions, and plan-related details to government health agencies overseeing Medicare Advantage and Part D prescription drug coverage programs.

The template contains 79 data fields organized to capture comprehensive beneficiary and enrollment information, including demographics (name, gender, date of birth), enrollment details (plan identification, transaction codes, effective dates), prescription drug coverage specifics (Part D premiums, subsidy amounts, pharmacy network identifiers), and processing metadata (timestamps, source codes, tracking numbers). Key field categories encompass beneficiary entitlement status, disability and institutional care indicators, low-income subsidy determinations, creditable coverage flags, employer subsidy information, and secondary insurance details. The structure accommodates multiple transaction types and enrollment sources while tracking changes through UI-initiated flags, prior plan information, and transaction reply codes. This standardized reporting mechanism enables state and federal agencies to monitor Medicare enrollment activities, verify beneficiary eligibility, process subsidy determinations, and maintain accurate records across contracted health plans and intermediaries.

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Text version

Sheet1

Schedule P TRR Report Template
RFP No. 230000003226

hicn surname first_name middle_initial gender_code date_of_birth record_type contract_number state_code county_code transaction_status_flag disability_indicator hospice_indicator institutional_nh_c_hcbs_ind esrd_indicator transaction_reply_code transaction_code entitlement_type_code effective_date working_aged_indicator plan_benefit_package_id transaction_date ui_initiated_change_flag field_24 district_office_code prv_prt_d_cntrct_pbp_trp_tnsfr source_id prior_plan_benefit_package_id application_date ui_user_organization_designation out_of_area_flag segment_number part_c_beneficiary_premium part_d_beneficiary_premium election_type enrollment_source part_d_opt_out_flag premium_wthhld_option_parts_c_d number_of_uncovered_months creditable_coverage_flag employer_subsidy_override_flag processing_timestamp secondary_drug_insurance_flag secondary_rx_id secondary_rx_group eghp prt_d_low_inc_prem_subsdy_lvl low_income_co_pay_category low_income_period_effective_date part_d_late_enrllmnt_pnlty_amt part_d_lep_waived_amount part_d_lep_subsidy_amount low_inc_prt_d_prem_subsdy_amt part_d_rx_bin part_d_rx_pcn part_d_rx_group part_d_rx_id secondary_rx_bin secondary_rx_pcn de_minimis_differential_amount msp_status_flag low_income_period_end_date lis_source_code enrollee_type_flag_pbp_level application_date_indicator trc_short_name drc fa_demo_opt_out_flag sys_assigned_trnsctn_track_id plan_assgnd_trnsctn_trck_id plan_transaction_text_a plan_transaction_text_b end_date submitted_uncovered_mths hospice_provider

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