CO 1919 – PE 834 Trans Modification There are no new fields or structural changes to the 834 or the 820 transaction. When a member moves from Risk-Based PE to Risk-Based Medicaid, INS03 will still contain “001” and INS04 will still contain “29” in the PE 834. This is the way it currently works in the production environment.  For Bisect and Retro members moving from RBMC to FFS, the following happens when we receive the ICES file notification of the change of eligibility from PE to Medicaid: A PE 834 file is generated that night with an 001/29 change record. A HHW 834C file is generated that night with an 024/07 term record.

CO 1919 – PE 834 Trans Modification   For Future dated members moving from RBMC to FFS, the following happens when HP receives an ICES file notification of the change in eligibility from PE to Medicaid: A PE 834 file is generated that night with an 001/29 change record. A HHW 834 will be generated with an 024/07 term record, the first time the managed care job runs after the future dated Medicaid eligibility starts.  This will normally be the first Saturday following the Medicaid eligibility start date.  If an ICES file comes over after the Medicaid eligibility start date and contains an event (like an address or name change) prior to the following Saturday, the HHW 834 would generate then.