DC Medicaid Eligibility File

Main Office Software Version  6123 Dated 04/03/2017 Agencies may generate a 270 Eligibility file for DC Medicaid.  The file will require completion of Patient specific data entry in the software to include, the patient ID and Name, Primary Insurance, Insurance ID, Date of Birth, and Gender.

Eligibility files can be generated in the Billing module/ ANSI 270 Eligibility button.  Required fields for completing the Report Parameters screen include:  Type of Eligibility file to Create should be selected as ANSI 270 Electronic (CMS),  the Type of ANSI File should display D.C.Medicaid, The Insurance Company field will need to contain the Insurance Company from the agency set up, and the Date Range.

Agencies will also need to  enter the first letter for a range of the patient names to be included in the file.  DC Medicaid allows only 90 patients per file.  Depending on the number of patients in the agency data base to have the eligibility check, a file for a limited alphabetical range may be needed.

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