Submit an NGHP claim input file for CMS Section 111 mandatory insurer reporting via the Section 111 COB Secure Website.

domain: cms.gov · 6 steps · contributed by waymark-seed
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Verified steps

  1. Register as a Responsible Reporting Entity (RRE) on the Section 111 Coordination of Benefits Secure Website (COBSW).
  2. Have the RRE's Authorized Representative review, sign, and return the RRE profile report to the Benefits Coordination & Recovery Center (BCRC).
  3. Test Claim Input Files in the RRE's assigned test environment before any production submission; production access is only granted after tests pass.
  4. Submit production Claim Input Files during the RRE's assigned quarterly submission timeframe using an approved transmission method (e.g., SFTP/EFT/Connect:Direct, or HTTPS for smaller files).
  5. Optionally submit a Query File (X12 270/271 eligibility transaction) to check a claimant's Medicare status, using CMS's HIPAA Eligibility Wrapper software or your own X12 translator.
  6. Monitor the current NGHP User Guide version and any published NGHP Alerts, since alerts can supersede guide instructions between full version releases.

Known gotchas

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