Background
To better control duplicate spending and reduce fraud, abuse and errors, CMS announced new reporting mandates for entities responsible for liability insurance, no-fault insurance and workers’ compensation. Responsible Reporting Entities must prepare to meet the challenge of a whole new set of electronic reporting requirements. Effective July 1, 2009, CMS will be requiring all RRE’s to send, on a quarterly basis, electronic transmission of a complex array of claims information that will help them better monitor who is responsible for paying a claim. This includes no-fault auto, workers’ compensation and general liability companies, plus companies that self-insure for those liabilities.
Solution
Ingenix has deep experience in electronic reporting of complex, detailed health information, whether it is submitting claims for group health insurers or state reporting requirements mandated by workers compensation agencies. Our expert staff continue to monitor the latest CMS reporting requirements as they evolve, and have experience with similar reporting requirements on the state level.
The Ingenix solution includes consulting focused on helping our customers understand the new mandate including workflow, data requirements and registration. It also includes an internet-based reporting tool, which is another module of our highly successful WorkComp.NET service.
Our experts can help every step of the way, from site registration and providing guidance on system design and eligibility determinations, to auditing and submitting the relevant data for those claims which must be reported. By helping to set up an efficient and effective reporting system, RRE’s will find that complying with the new quarterly reporting mandate is easier than expected.
Value
- Compliance
- Efficiency
- Increased accuracy
- Validation edits on a batch and file level
- Dual eligibility and reporting capabilities
