Medicare

List of Functional Requirements for Medicare module:

  • 1. Build a Medicare file containing Members who have assigned their Part B Medicare benefit to Funds (the system produces Medicare Transaction/Transfer File to be sent to HCFA).
  • 2. Import Medicare Roster from HCFA and based on this information produce discrepancy reports
  • 3. Enroll members in Medicare and provide online inquiry of existing Medicare enrollees
  • 4. Calculate member’s entitlement for Medicare based on eligibility for Health Centers and Pharmacy
  • 5. Maintain the scans of Medicare Card, Enrollment Form and Disclosure Form
  • 6. Online inquiry of working members who lost their Health Center Eligibility
  • 7. Conversion of enrollment information from NCS
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