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Medicare Agent Reporting Services

Section 111 MSP reporting enables CMS to determine primary versus secondary payment responsibilities and correctly pay for Medicare covered items and services furnished to Medicare beneficiaries. Section 111 requires Responsible Reporting Entities (RRE's) to submit information electronically to the CMS Coordination of Benefits Contractor (COBC).

Non-GHP User Guide

What is an RRE?

42 U.S.C. 1395y(b)(8) defines a responsible reporting entity to be an applicable plan:

"Applicable plan means the following laws, plans, or other arrangements, including fiduciary or administrator for such law, plan, or arrangement:

Liability insurance (including self-insurance)
No fault insurance
Worker’s compensation laws or plans”

Section 111 RRE's are required to register with the COBC and fully test the data submission process before submitting production files. RRE's will then be assigned a quarterly file submission timeframe during which they are to submit files.

The timeline for reporting is as follows:

5/1/09 - present: Electronic registration via the Coordination of Benefits Secure Website for all liability/no fault/worker's compensation RRE's

7/1/09 - present: Testing and production of Query files for all liability/no fault/worker's compensation RREs who are in a "Testing" status on the COB secure website

1/1/2010 - 12/31/10: Claim Input File testing period for all NGHP RREs

1/1/2011 - 3/31/2011: NGHP RREs reporting Ongoing Responsibility for Medicals must submit their initial Section 111 production files based upon a pre-determined schedule with the COBC.

4/1/2011: NGHP RREs reporting Ongoing Responsibility for Medicals must be reporting production Claim Input Files on a quarterly basis by this date.

1/1/2012 - 3/31/2012: NGHP RREs reporting Liability TPOC amounts on or after 10/1/2011 must submit their initial Section 111 production files based upon a pre-determined schedule with the COBC

Novare's Medicare Agent Reporting Services are available to RRE's to provide MMSEA 111 compliance.

Provide up-front consulting to help client register, understand data requirements/timing/process, and identify appropriate claims
Retrieve query files from RRE, query CMS database, and identify appropriate Medicare-eligible claims
Retrieve import file from RRE
Edit file for mandatory and optional data elements
Enable interface function to correct missing elements on-line
Transmit final report file to CMS
Send acknowledgement notification to RRE
Manage reporting for RRE

SSN and HICN collection model language

Toll Free: 866-532-1929
Phone: 985-845-4548
Fax: 985-845-9913

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