AHCCCS Technical Interface Guidelines (TIG)

 

Health Plan Interface - Open Enrollment Potential Transition Listing Process


Introduction

The Open Enrollment Potential Transition Listing Tapes provide the Health Plan with the basic demographic information of all members who may be joining or leaving the plan.

Important Note: Listing should not be confused with Enrollment Notification data. Whereas Enrollment Notification data, once delivered to the Health Plan, is considered legal notification, this is only preliminary information based on the member's choice during the Open Enrollment Period.

The Health Plan can use this information to begin preparing for the new members joining their plan and the transition of the members leaving their plan.

 

Schedules

  • Open enrollment occurs on an as-needed basis. File is named ccyymm.PTL and is available in the plan’s folder under AZ/hpmnemonic/PROD/OUT

 

Media

The Open Enrollment Potential Transition file is available on the AHCCCS FTP server.

 

Testing

Active Care notification file transmissions must be tested in coordination with the AHCCCSA ISD operations staff prior to production implementation of a new Health Plan or change in service bureau, or as a result of changes. Typical testing of file transmission takes approximately one week and must be completed prior to implementation of any new processing arrangement.

 

Reference Documents