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Multiple PMI numbers

Rochelle Garcia 1 year ago in Industry News/Discussion updated by Shauna Dall 1 year ago 5

I was just wondering if anyone knows of another site other than MNITS to check insurance eligibility (besides individual PMAP sites).  Im finding that many clients have multiple PMI numbers and unfortunately on MNITS you will just get the response:

  • Invalid/Missing Subscriber/Insured ID.
    Please Correct and Resubmit."

When I've called DHS before one person explained that this error may mean there is more than one PMI and the next time I called I was told they were not supposed to give us this information.  Most of our client's are in home clients and its difficult to get a hold of parents to get any insurance information from them. How does this corrected? I've sent claims to Hennepin County and they have been returned as having an active PMI but again I dont have this new information so how can providers know this.  

I work at a Residential treatment facility and we are having the same issue here. Many of our clients are funded through counties and even at the county level, they are unable to catch the clients with multiple PMIs. I have been told this is a known issue and that DHS has been made aware of it, but that as of yet there is no known resolve and they will continue to work on it. This is definitely not good news and I would love to hear if anyone knows a better way to deal with this!

Hi Rochelle, we usually find out from our Program Assistant when they sign the patient up with MA, a duplicate PMI arrives. You can also call the DHS help desk or email their county worker to find out. When a duplicate PMI arrives we always email DHS and asked for the two numbers to be merged under the active PMI. Here is that email: dhs.tss.pmi@state.mn.us 

Here is the DHS Guidance to Counties re: Duplicate PMI.  I think many entities have sent a 'fix it' email to the link below, in addition to calling the provider line listed at the bottom to fix.  I've called a few times, it usually takes a few weeks and then I have to go back in and resubmit claims.  I was not notified that the fix happened, I just went back in and resent and claims paid.

Duplicate Person Master Index (PMI) numbers
Report duplicate PMIs to the Transition Support Systems (TSS) PMI Team (now part of the Data Integrity &
Incident Response Team). That team works to correct the duplicate PMIs.
How should I report duplicate PMIs?
MAXIS and county staff: Report duplicate PMIs in MAXIS using the PF11 TRBL key or by completing the TSS
PMI Merge Request Form. This form can also be found on SIR under the MAXIS main page>Web Form
Links. The TSS PMI Team prefers the PF11 method, as that provides a better means of tracking the request
and researching it if the duplicate was previously reported.
DHS staff: Report duplicate PMIs by sending an Outlook email to DHS.TSS.PMI@state.mn.us. Your request
will be automatically entered in the TSS help desk’s new tracking system, called Customer Relationship
Management (CRM).
All staff: Please report all duplicate PMIs you have identified for the same person and include the MAXIS,
MMIS or METS case numbers associated with them.
What if a request is urgent?
The TSS PMI Team works nonurgent requests in order of date received.
You may submit an urgent request if the duplicate PMI is preventing the person from getting cash, food or
medical benefits the person is entitled to. To submit an urgent request, do the following:
 For requests submitted by PF11 or email, include the word “Urgent” in the subject line.
 For requests submitted by form, include the word “Urgent” in the “Request Description” section.
 Briefly explain why the request is urgent.
How does the duplicate PMI merge process work?
The automerge process determines which PMI should be kept for ongoing use (the “keeper”). Duplicate
PMI automerge programming was written based on data in MAXIS, which holds the PMI data. Merge logic
for deciding the keeper is based mainly on MAXIS case associations. The automerge process looks to see
whether one of the PMIs is active on any MAXIS case. If one of the PMIs is active in MAXIS, it will be the
keeper. If none of the PMIs is active in MAXIS, the newest PMI is chosen as the keeper, based on MMIS
preferences. Once the process determines the keeper PMI, it merges the other PMI(s) with the keeper.
What happens after the duplicate PMIs are merged?
The automerge process does not involve removing eligibility spans from one PMI and adding them to
another. The coverage spans remain on the nonkeeper PMI with an end date in MMIS on RELG. Providers
should use the old PMI to bill for any services provided during the period the old PMI was active.
Providers must use the keeper PMI to bill for any services after the PMIs have been merged, as it will
contain the ongoing eligibility.
In some urgent situations involving PMIs created from METS, the DHS County Relations Resource Center
(CRRC) worked with the TSS PMI Team to manually merge PMIs. This resulted in the CRRC’s having to
move all eligibility spans from the old (nonkeeper) PMI to the (keeper) PMI. In November 2017 we
discontinued this process.
Minnesota Department of Human Services 2 June 2018
When the merge is complete, you will see the following messages in MMIS, depending on which PMI you
look up:
 Under the nonkeeper PMI, you will see this message:
PMI # ENTERED xxxxxxxx (non-keeper) IS EXPIRED; PMI # UPDATED TO xxxxxxxx (keeper)
 Under the keeper PMI, you will see this message:
PMI # ENTERED xxxxxxxx (keeper) HAS DUPLICATE PMI # xxxxxxxx (non-keeper)
What happens if the automerge fails to complete?
Sometimes the automerge process does not successfully complete and requires worker intervention. DHS
generates a PMI Merge ‘Stop’ Processing report that identifies instances in which this happened. The
report lists error code(s) that must be resolved by one of the following DHS groups: CRRC, Disability
Services Division, Aging and Adult Services Division or Chemical Health Services Division. The final merge
takes place once all errors are resolved in MMIS and the PMIs no longer appear on the report.
Problem resolving PMIs on the PMI Merge ‘Stop’ Processing report
In 2014, DHS started to see an increased number of duplicate PMIs created from METS that the TSS PMI
Team had tried to automerge but that then appeared on the PMI Merge ‘Stop’ Processing report. The
team found it could not resolve the error codes and thus could not complete the final merge. As result,
the team halted the automerge process for requests involving a PMI generated from METS, and this
created a backlog of those requests.
DHS worked with Minnesota IT Services to determine why we could not get the PMIs generated from
METS off the report. It was discovered that a coding change was required. The fix went into production in
November 2017. The TSS PMI Team was able to resume the automerge process for all duplicate PMIs. The
team is currently working on requests that came in during March 2017, from a backlog that originally
went back to July 2014. The team has accomplished a lot in a short time. The CRRC and other DHS
business areas are now able to successfully resolve all duplicate PMIs that appear on the PMI Merge
‘Stop’ Processing report.
What if I have questions once the duplicate PMIs are merged?
Managed care
If you have questions about a PMI merge for a particular managed care case, please submit an HPEN
trouble ticket or contact your county enrollment coordinator.
DHS Managed Care receives a daily merge report. This report identifies the managed care end date for
each nonkeeper PMI, whether overlapping eligibility exists and whether overlapping managed care exists.
If a person has nonkeeper PMIs that are closed for the current month, DHS enrolls the person in the same
managed care plan for the next month under the keeper PMI. The person’s keeper PMI must have current
eligibility, and the health plan must be available in the county of residence.
DHS recovers any duplicate capitation payments that were made as a result of duplicate PMIs. DHS sends
health plans a daily report of the duplicate capitation payments it recovers.
Fee-for-service
Members who need to report an issue after a merge is completed should call the MHCP Member Help
Desk at 651-431-2670 or 800-657-3739.
Providers with questions about claims payments or eligibility before or after a merge is completed should
call the MHCP Provider Call Center at 651-431-2700 or 800-366-5411.

Thank you for sharing this, Shauna!