Prepare for CMS Reporting
ISO ClaimSearch® has created a service to help you comply with the mandatory claims-reporting requirements of Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007.
In February, the Centers for Medicare & Medicaid Services (CMS) changed the initial production date for submitting non-group health plan (NGHP) input files from April 1, 2010, to January 1, 2011. The new production date gives your company more time to prepare.
CMS reporting checklist
If your company has signed up for the ISO ClaimSearch Medicare Secondary Payer Reporting Service, there are a number of steps you must take before you can begin reporting claims.
To help you get ready, we’ve created a checklist of activities your company must complete before January 1, 2011.
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Has your company . . .
- registered with CMS?
- received its RRE code(s) from CMS?
- received its quarterly reporting period (from 1 to 12) from CMS?
(Note: The number corresponds to the twelve weeks of the fiscal quarter. If CMS has assigned your company to the first reporting period, your company must submit its report to CMS during the first week of reporting.)
- indicated its CMS account manager?
(Note: CMS account managers are authorized representatives who will receive a profile report by e-mail from CMS.)
- provided ISO with at least one site ID per TIN (tax identification number)?
(Note: CMS will return correspondence to this site ID.)
- completed and returned its signed CMS profile?
- confirmed that all its RREs are in testing status?
- registered all four ISO account designees with CMS?
The four ISO account designees are:
- John A. Giknis:
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- Lynn M. Roberts:
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- Bryan Berkowitz:
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- Marilyn Orthouse:
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Remember, you must use Universal Format to report claims to ISO ClaimSearch. We cannot submit legacy claims to CMS. The legacy format doesn’t include all the necessary data fields that CMS requires.
Optional services can help you submit claims to CMS
If you want ISO ClaimSearch to query the CMS database, you must include four key claimant fields:
- claimant name
- date of birth (DOB)
- Social Security number (SSN) or Health Insurance Claim Number (HICN)
- gender (male, female, or not known)
If you don’t have information for all four fields, ISO offers optional services:
Automatically performs a public-records search to find the information you need to comply with CMS requirements
Batch SSN and DOB service
Allows you to append the Pre-Query Extract File with missing Social Security numbers and dates of birth
Shows you the claims your company submitted and what information may be missing
For more information about the ISO ClaimSearch Medicare Secondary Payer Reporting Service, visit www.iso.com/msp or call ISO ClaimSearch Customer Support at 1-800-888-4476. If you have questions, send e-mail to our ISO ClaimSearch Medicare Secondary Payer Reporting Service mailbox:
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