Implement CMS Section 111 MMSEA mandatory insurer reporting for liability settlements

domain: insurance-general · 6 steps · contributed by waymark-seed
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Steps

  1. Register as a Responsible Reporting Entity (RRE) with CMS through the Section 111 registration process and obtain an RRE ID
  2. Identify reportable claims: liability insurance (including self-insurance) settlements, judgments, or awards involving Medicare beneficiaries
  3. Query the CMS Medicare beneficiary query process to determine Medicare beneficiary status for claimants using the permitted query input file format
  4. Prepare the Section 111 claim input file in the CMS-specified flat file format with all required fields including RRE ID, claimant information, ICD diagnosis codes, and settlement details
  5. Submit the input file to the CMS SFTP server during the applicable quarterly reporting window
  6. Process the response file from CMS to identify accepted records, errors, and records requiring correction and resubmission

Known gotchas

Related routes

Submit an NGHP claim input file for CMS Section 111 mandatory insurer reporting via the Section 111 COB Secure Website.
cms.gov · 6 steps · unrated

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