CMS: Helping Members Resolve Data Matching Issues (DMIs)

CMS Messaging to Agents/Brokers about Resolving DMIs:

Subject Line: Resources to Help Consumers Resolve Data Matching Issues

Headline: Understanding How to Help Consumers Resolve Data Matching Issues

Agents and brokers play a vital role in helping consumers understand and follow the correct process to resolve data matching issues (DMIs). DMIs are the result of inconsistencies between the data submitted on a consumer’s Marketplace application and the data the Centers for Medicare & Medicaid Services (CMS) obtains from other trusted data sources. To learn more about helping consumers resolve DMIs, check out this video.

Common causes of DMIs include:

• Information does not match because a trusted data source does not have data for a consumer.
• The consumer’s application includes missing or incorrect information, such as:
• The consumer didn’t provide a Social Security Number (SSN) on the application.
• The consumer didn’t provide all household income on the application.
• The consumer’s name on the application differs from how it appears on their citizenship document or another document.
• The consumer didn’t provide their immigration document numbers and/or ID numbers on the application.

Agents and brokers can help consumers by ensuring they follow the correct process to submit the appropriate documentation to resolve DMIs before the applicable deadlines. Otherwise, the consumer risks losing their coverage or financial assistance, including advance payments of the premium tax credit (APTC) and/or cost-sharing reductions (CSRs), and agents and brokers risk losing commissions.

To learn more about resolving DMIs, check out more resources:

• Agent/Broker Frequently Asked Questions (FAQs)
• Webinar Slides: How to Resolve Income DMIs
• Webinar Slides: Helping Consumers Throughout PY 2023

If you have any questions, call us today at 866-568-9649!