Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: April 08, 2016

Program Area: Vendor Management, Payments, and Collections (VMPC)

Question: How should Issuers report an incorrect Exchange-assigned Policy ID on the Dispute and Discrepancy Resolution form?

Answer: In this instance, issuers should not report this as a payment dispute. For a given subscriber, the exchange assigned policy ID reported on the PPR/820 is the correct policy ID and should be used by the issuer. If an issuer is maintaining a different exchange assigned policy ID for a subscriber than what the Preliminary Payment Report (PPR) and HIX 820 are reporting payments for, issuers will need to work internally to align the subscriber to the correct exchange assigned policy ID as reported in the PPR/820.

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