JERSEY CITY, N.J., February 23, 2009 — ISO ClaimSearch®, the property/casualty insurance industry’s only comprehensive claims information system, announces the development of a new regulatory compliance service: the ISO ClaimSearch Medicare Secondary Payer Reporting Service.
Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007 (P.L. 110-173) adds new mandatory reporting requirements for group health plan arrangements and for liability insurance (including self-insurance), no-fault insurance, and workers compensation. The legislation requires reporting of bodily injury claims filed by Medicare-eligible claimants to the Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS). The requirements apply to insurers and self-insured organizations.
The ISO ClaimSearch Medicare Secondary Payer Reporting Service will report Medicare-eligible claimants to CMS on behalf of ISO ClaimSearch participating companies in conformance with the legislation. Reporting through ISO will provide insurers and self-insureds with significant savings and process efficiencies by leveraging the existing claims reporting process for companies using the ISO ClaimSearch Universal Format reporting specifications.
ISO, in conjunction with insurers and the insurance trade associations, has held discussions with CMS about the required data elements and reporting processes. ISO’s service — including a Medicare-eligibility query function, data collection and editing, automated claim file submissions, and processes for handling CMS acknowledgment and rejection notices — will allow ISO ClaimSearch customers to comply fully and cost-effectively with the mandate.
Companies are required to register their data-reporting method with the CMS by June 30, 2009. CMS will assign a quarterly reporting period to each required reporting entity at registration. Companies must be ready to test reporting to CMS on July 1, 2009. The deadline for submission of production files based on the predetermined quarterly reporting schedule is January 1, 2010. All applicable claims open as of July 1, 2009, must be reported. ISO will support the testing process and manage the quarterly submissions on behalf of companies that subscribe to the ISO ClaimSearch Medicare Secondary Payer Reporting Service.
For more information and to be added to the Medicare Secondary Payer Reporting Service information contact list, contact Bryan Berkowitz, ISO ClaimSearch compliance specialist, by telephone at 201-469-3095 or by e-mail to the ISO ClaimSearch Medicare Secondary Payer Reporting Service mailbox, firstname.lastname@example.org.
About ISO ClaimSearch
ISO ClaimSearch serves hundreds of participants, supporting their claims-adjudication and fraud-detection activities. Participants include insurers representing 93 percent of the property/casualty insurance industry; hundreds of public and private self-insureds, including municipalities, government agencies, and Fortune 500 companies; 26 state workers compensation insurance funds; 480 third-party administrators (TPAs); several state fraud bureaus; and many law enforcement agencies involved in investigation and prosecution of insurance fraud. The system also provides a range of compliance support functions to assist participants in meeting mandatory and voluntary reporting requirements in many jurisdictions.
A leading source of information about risk, ISO provides data, analytics, and decision-support services to professionals in many fields, including insurance, finance, real estate, health services, government, human resources, and risk management. Using advanced technologies to collect, analyze, develop, and deliver information, ISO helps customers evaluate and manage risk. The company draws on vast expertise in actuarial science, insurance coverages, fire protection, fraud prevention, catastrophe and weather risk, predictive modeling, data management, economic forecasting, social and technological trends, and many other fields. To meet the needs of diverse clients, ISO employs an experienced staff of business and technical specialists, analysts, and certified professionals. In the United States and around the world, ISO helps customers protect people, property, and financial assets.