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Responsible Reporting Entity (RRE)

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June 27, 2019

Think about your thresholds: Preventing errors to avoid CMS penalties

One way responsible reporting entities can attempt to achieve full CMS compliance and avoid potential penalties is to closely consider file thresholds.

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June 17, 2019

Big reforms are coming to Michigan PIP - How the changes will impact Medicare Secondary Payer compliance

On 5/30/19, Governor Gretchen Whitmer signed Michigan Senate Bill 1, which makes significant changes to Michigan’s personal injury protection (PIP) system.

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June 14, 2019

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…

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May 31, 2019

To avoid CMS penalty exposure time is of the essence

The timely reporting of ORM and TPOC data to CMS is of key importance to insurers, especially now enforcement of noncompliance penalties is on the horizon.

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February 28, 2018

Medicare watch list: Staying ahead of the Medicare Secondary Payer compliance curve

As another new year settles in, we know at least one thing is certain: MSP compliance will continue to present formidable challenges for claims payers.

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December 21, 2017

CMS Releases New Section 111 NGHP User Guide (Version 5.3)

The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 non-group health plan (NGHP) User Guide (Version 5.3, December 15, 2017).

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July 7, 2017

Medicare Section 111 process change eases one compliance burden

RREs will no longer automatically be moved into “discontinued” status if they fail to provide Medicare the requested annual recertification information.

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September 22, 2015

Deep dive: Clinical trials and Section 111 reporting

When it comes to clinical trials, there are a range of possibilities. Although CMS generally doesn’t consider ORM likely in liability claims, it exists in certain…

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June 22, 2015

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…

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June 22, 2015

Using the Section 111 query process to your benefit

Responsible reporting entities (RREs) are required first to identify Medicare beneficiaries and then report certain data to Medicare in the form and manner specified by…

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February 20, 2015

ICD-10 update

One of the most important developments in Medicare Secondary Payer compliance for 2015 will be the transition from ICD-9 codes to ICD-10 codes on October 1, 2015. On that…

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December 2, 2014

CMS releases new Section 111 alert regarding SSNs

CMS has released a new NGHP Section 111 alert providing additional information regarding its plans to allow RREs to submit partial social security numbers (SSNs) for…

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November 17, 2014

CMS alert: Introducing recovery agents

The Centers for Medicare and Medicaid Services (CMS) has released a technical alert outlining the role of a designated recovery agent in Medicare Secondary Payer (MSP)…

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