In a May 25 alert, the Centers for Medicare and Medicaid Services (CMS) announced the development of a new direct data entry system for “small reporters,” defined as a Responsible Reporting Entity (RRE) that will submit 500 or fewer non-group health plan (NGHP) claim reports per year.
The low-volume reporting option should be considered by RREs that will only have occasional claims to report as there is a limit of 500 reports per year. Reports that don’t match up with beneficiary information or yield a “no match” response will count against the 500-per-year reporting limit.
CMS created this new user-friendly online system as an alternative to building a full-blown, expensive data exchange. The April edition of HB’s Medicare Secondary Payer newsletter reported that CMS was in the process of making it more expedient for low-volume NGHP reporters to submit claim information. Currently, there are approximately 24,000 NGHP RREs registered with CMS, most of which are self insureds, CMS told HB.
“Small reporters” that use the direct data entry option have the same responsibility and accountability as any other RRE. But the new system is different in some ways from the high-volume reporting system. For example, no testing will be required for the “small reporter” data entry system, there is no assigned submission window, claim information will be submitted one report at a time, and a separate query function will not be available.
Learn more about how to report, when to register and factors to consider if you or your client typically encounters a few hundred injury claims per year or less in the May edition of HB’s Medicare Secondary Payer Newsletter. Click to subscribe or email us for one free issue at email@example.com.