US · guidance
CMS Pub. 100-04, ch. 27, § 20.3.3
Not in Host's File (NIF)
When the Host receives a claim record from a MAC, it first searches its beneficiary and
cross reference files. If it does not find the beneficiary's record in either place, it searches
the Transfer Not in File (TNIF) file. If the record is not found there, the Host puts a
response on the reply record in the form of a disposition code 50 or 52, indicating that the
Beneficiary Record for which the MAC submitted a claim record is not located at the
MAC's Host.
The TNIF file contains a record of every beneficiary for whom the Host has received a
claim, and whose records are located at another Host. It shows at which Host the
beneficiary file resides. If the Beneficiary Record is located at another Host, the original
Host checks the out-of-service area response file to see if the claim record response is
already waiting there. If there is not a response waiting, the claim is sent to the proper
Host for processing. If there is a response, the Host gives that information to the MAC.
There are many disposition codes that are returned to the MAC for various NIF
situations. Following is a list of codes and actions the MAC takes in response to each
disposition code.
History
(Rev. 4009, Issued: 03-23-18, Effective: 04-23-18, Implementation: 04-23-18)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
e84fb233b75265446828c8312d7f169df3f95894cbc7308fd35fb4b4ef68aa05
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