Match Criteria 1. HIC#: Health Insurance Claim # (Medicare ID#) 2. Last Name: First 6 characters, including spaces and special characters. 3. First Name: First 3 characters, including spaces and special characters. 4. Middle Initial: Middle initial alone will not cause buy-in to reject. 5. Date of Birth: Month & Year 6. Sex Code: M or F 7. SSN: Client’s own SSN Match Criteria Last Name First Name Middle Initial DOB Sex First 6 characters First 3 characters SOLQ will only Month & Year M including spaces If you see the full display the Day of Birth alone, Or and special middle name separated middle initial, or middle initial F characters. from the first initial by never the full alone will not cause a space, enter what you middle name. buy-in to reject, but see into the first name both together will field in CBMS Case cause a reject. Summary & Individual Demographics Buy-In Buy-In Premium Premium Payer Code Option Code Start Date Stop Date Start Date Stop Date Z99 = Y = Premium Populated if Populated if First month of First month of Conditional is payable state has buy-in has entitlement; S01-S99 = E = Free Part started buy-in stopped (end zeroes if not State A (1st of the of the month); enrolled zeroes if Payment Blank = not month); zeroes if entitlement Blank = Self enrolled zeroes if no is ongoing ongoing or Pay if Option buy-in. or never never Code = Y, started. enrolled. HIC# (Health Insurance Claim #, aka Medicare ID) Enter the complete HIC#, including the BIC (Beneficiary Identification Code). No zeroes in the BIC.
Match Criteria 1. HIC#: Health Insurance Claim # (Medicare ID#) 2. Last Name: First 6 characters, including spaces and special characters. 3. First Name: First 3 characters, including spaces and special characters. 4. Middle Initial: Middle initial alone will not cause buy-in to reject. 5. Date of Birth: Month & Year 6. Sex Code: M or F 7. SSN: Client’s own SSN Match Criteria Last Name First Name Middle Initial DOB Sex First 6 characters including spaces and special characters. First 3 characters If you see the full middle name separated from the first initial by a space, enter what you see into the first name field in CBMS Case Summary & Individual Demographics SOLQ will only display the middle initial, never the full middle name. Month & Year Day of Birth alone, or middle initial alone will not cause buy-in to reject, but both together will cause a reject. M Or F Payer Code Option Code Buy-In Start Date Buy-In Stop Date Premium Start Date Premium Stop Date Z99 = Conditional S01-S99 = State Payment Blank = Self Pay if Option Code = Y, Y = Premium is payable E = Free Part A Blank = not enrolled Populated if state has started buy-in (1st of the month); zeroes if no buy-in. Populated if buy-in has stopped (end of the month); zeroes if is ongoing or never started. First month of entitlement; zeroes if not enrolled First month of zeroes if entitlement ongoing or never enrolled. HIC# (Health Insurance Claim #, aka Medicare ID) Enter the complete HIC#, including the BIC (Beneficiary Identification Code). No zeroes in the BIC.