834 Transaction - Benefit Enrollment

Overview

The 834 Transaction is the HIPAA-compliant Benefit Enrollment and Maintenance Transaction. Its purpose is to electronically transmit enrollment and dis-enrollment information.

In 2004, DHCS implemented a 4010 834 solution, however, this was implemented along with a supplemental transaction that held eligibility history.

The HIPAA 5010 version of all transactions is scheduled to be implemented on January 1st, 2012. DHCS will implement a compliant 5010 834 on this date. The current FAME file will continue to be made available for a short period of time after this date to allow plans time to transition. Once this transition period has been completed the FAME file will no longer be made available to managed care plans.

Impacted Covered Entities

Internal DHCS program areas and DHCS Health Plan trading partners.

Links

General Fame Documents

Medi-Care Part D Information

5010 834 Documents

NOTE:  5010 834 Companion Guide Documents have been temporarily removed for maintenance.

Generic Test Data Non-COHS FAME - v2.txt

5010 834 Generic Test Data Overview (pdf)

DHCS 834-DA20110712 - Medical-123-HCP-001.txt

DHCS 834-DA20110712 - Dental - 495-HCP-001.txt

DHCS 834-DA20110712 - Dental - 4912-Vendor-001.txt

General FAME Documents

FAME Data Element Dictionary (pdf)

MEDICARE PART D INFORMATION

Project Information 

DHCS Medicare Part D information web page

MMA Part D Carrier Cross Reference Table (pdf)

File Layouts

MMEF 2100 Medicare Part D layout (pdf)

MMEF REC Medicare Part D layout (pdf)