Online Manditory Insurer Reporting

Mandatory Insurer Reporting Requirements of Section 111 of the MMSEA (Medicare, Medicaid and SCHIP Extension Act of 2007) will require the providers of group health plan, liability insurance, self-insurance, no fault insurance and workers’ compensation insurance to mandate submission of eligibility for potential Medicaid Part A, B and D recipients.  Failure to comply with reporting requirements is a civil penalty of $1,000.00 per day for each individual for which the information should have been submitted.

Key Technical Elements:

There are many challenges facing the affected parties including (but not limited to) the following;

  • The Ability to support 270/271
  • Ability to process and categorize disposition codes
  • Ability to identify, store and host a secure site for entry of SS# for insured AND dependents
  • Ability to identify “active covered individuals” for submission
  • Hosting new data fields for eligibility
  • Automation of quarterly submission updates
  • Work Queues for SP reject queues
  • Plus, many more

With LSIdata’s Assistance These Challenges are Manageable.

With the limited timeline and substantial financial penalties, you and your company do not have time to waste.  As your registered “agent”, LSIdata can assist you in the following ways:

  • Assist you with the registration process for COBC
  • Manage the file testing requirements for both the beneficiary inquriry and claim data files.
  • Robust, secure online application built on n-tier architecture
  • Ability to manage your initial and quarterly eligibility submissions to COBC.
  • Reformat your file of insured’s so it is accepted by COBC.
  • Provide a web interface to change the insured information where needed.
  • Handle/process rejects to COBC with SP disposition coded by providing you an interface for corrections
  • Track and crosswalk all DCN, adjudication numbers and HICN numbers
  • Provide real time reporting and alerting to always keep you updated.
  • Manage active covered individuals and the TINS they are affiliated with
  • Send the proprietary file to COBC
  • Manage the SS# gathering that is required
  • Manage the MSP # returned from CMS with ‘01’ disposition code
  • Handle new data field needs
  • Manage communication and alerts from COBC
  • Low cost of ownership and maintenance
  • Ongoing support to make changes to updates from CMS

 

We specialize in reporting for legacy systems