Ongoing Responsibility for Medicals (ORM)

Think about Your Thresholds: Preventing Errors to Avoid CMS Penalties

We’ve been taking a look at some of the ways RREs can attempt to achieve full CMS compliance and avoid potential penalties that may be coming soon. One area to consider more closely is file thresholds. Upon submission...

Avoiding Penalty Problems by Ensuring Data Accuracy

With CMS (Centers for Medicare and Medicaid Services) penalties on the horizon, we’ve been exploring how RREs (Responsible Reporting Entities) can be proactive in avoiding fines. We covered timely reporting in our...

To Avoid CMS Penalty Exposure Time Is of the Essence

The timely reporting of ORM (Ongoing Responsibility for Medicals) and TPOC (Total Payment Obligation to Claimant) data to the Centers for Medicare and Medicaid Services (CMS) is of key importance to insurers, especial...

With Civil Money Penalties Looming, It’s Time to Fine-Tune CMS Reporting

For insurance carriers and self-insureds—known as Responsible Reporting Entities (RREs)—Section 111 can be a daunting obligation. In fact, it’s the only Medicare Secondary Payer (MSP) compliance area associated with a...

MSPRP Update: CMS Announces a New Self-Reporting Option and Updates to the Multi-Factor Authentication Process

The Centers for Medicare and Medicaid Services (CMS) hosted a webinar focusing on enhancements to its Medicare Secondary Payer Recovery Portal (MSPRP) on December 18, 2018. The improvements discussed by CMS included a...

Deep Dive: Clinical Trials and Section 111 Reporting

ISO Claims Partners is dedicated to demystifying Section 111. Today I’d like to take a deep dive into one reporting trigger of Ongoing Responsibility for Medicals (ORM) by exploring clinical trials. Created by CMS...

Medicare Conditional Payment Compliance: Myth vs. Fact

The statutes and regulations that govern Medicare have been referred to by courts as “ the most completely impenetrable texts within human experience .” With the complex nature of Medicare compliance comes the resulti...