CMS Section 111 (MMSEA) Medicare, Medicaid, and SCHIP Extension Act of 2007. – Clients have been enjoying the handsfree touchless compliance capabilities of the new NAVRISK VISION CMS Reporting partner program with Franco Signor. This automated program makes it easier and faster to send data to CMS and helps avoid penalties that can be as much as $1,000 per day. In short, Section 111 of the MMSEA requires liability insurers and employers (both public and private) to electronically report to Medicare the details of settlements, judgments, awards or other payments to Medicare recipients.
The purpose of Section 111 NGHP reporting process is to enable CMS to correctly pay for the health insurance benefits of Medicare beneficiaries by determining primary versus secondary payer responsibility. Section 111 authorizes CMS and Section 111 NGHP responsible reporting entities (RREs) to electronically exchange health insurance benefit entitlement information. The actual data exchange process takes place between the RREs and the CMSBenefits Coordination & Recovery Center (the BCRC). On a quarterly basis, a responsible reporting entity (RRE) must submit a Non-Group Health Plan (NGHP) entitlement information about employees and dependents to the BCRC. In exchange, the BCRC will provide the RRE with Medicare entitlement information for those individuals in an NGHP that can be identified as Medicare beneficiaries. This mutual data exchange helps to assure that claims will be paid by the appropriate organization at first billing.
Having a defined plan for MMR data management is a real requirement. Starting with the right claims data edits and filtering options can pay dividends. MMR return of investment is usually achieved in just a few months. Our subject matter experts are available to answer your questions related to Medicare Reporting in more detail and further explain how NAVRISK — Franco Signor Medical Reporting can help ensure you are meeting compliance regulations. Schedule a Demo today.
Click here to read the NAVRISK VISION CMS Whitepaper Entitled “Overcoming Claim Data System Challenges With Medicare Reporting”.