Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server FAQ
Guidance for FAQ regarding Edge Server Operations and Other
Program Area: Distributed Data Collection (DDC) for RA Including HCRP/EDGE Server
Question: How will issuers know if a claim is orphaned? Orphaned claims are defined as having no enrollment period record associated with a submitted claim?
Answer: Outbound reports of claims without enrollee records and enrollees without claims will be provided at intervals to be determined in the near future. These outbound reports will be provided prior to identifying claims eligible for risk adjustment and reinsurance.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: July 23, 2013
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