Passport has received numerous questions about ACA and HIX responses. Please see the following information put together by our payer group.
- There is not one database that includes all members of the HIX. Membership is maintained by the individual payers.
- Initial conversations with some of our larger payers, have indicated that eligibility data for the ACA membership should be available through our current payer connections. There should be no need to establish new connections or change any of our existing connections.
- The organization that manages the EDI eligibility transaction ( ASC X12) has provided the payer community with a standard to follow for identifying ACA members and tracking the 90 day premium grace period. Because this is a suggested format and not a requirement, we anticipate that responses will vary significantly by payer.
- Only a small number of payers have communicated the changes they will be making related to the Affordable Care Act and their eligibility responses. As we receive updates from our payers and clearinghouses, we will post them on the dashboard.
- Passport is conducting an ongoing audit of eligibility responses for 20 of the health plans participating in the healthcare market place. We are reviewing responses to determine how each plan is identifying HIX members and how they are communicating the 90 day grace period.
- Once we’ve completed our research, we will be able to build appropriate processes to best manage the data.
