On Tuesday October 5th the Centers for Medicare & Medicaid Services (CMS) published version 6.5 of the NGHP User Guide. There are a number of substantive changes, although nothing earth-shattering. As with prior key updates, ExamWorks Compliance Solutions is here to give you all the important details on what has changed in this version. Here… Read more »
CMS has posted two updates this week:
The Total Payment Obligation to the Claimant (TPOC) threshold for reporting Section 111 claims and for Conditional Payment recovery efforts will remain at $750 for the 2020 calendar year. The Alert is available here.
CMS will be hosting a town hall meeting on January 14, 2020 at 1pm EST to discuss common Commercial Repayment Center (CRC) Ongoing Responsibility for Medicals (ORM) recovery topics.
On November 18, 2019, CMS released an alert titled, “Important Reminder for Non-Group Health Plan (NGHP) Responsible Reporting Entities (RREs) Regarding Medicare Beneficiary Identifier (MBI) Reporting.” A copy of the alert can be found here. The alert conveys no substantive changes to MMSEA Section 111 Reporting. Rather, this alert simply provides clarification on how RREs are… Read more »
Holding true to the suspicion that a new User Guide is released during a holiday, CMS recently published version 5.6 of the NGHP User Guide. Updates in this new version include: A Windows 10 version of the HIPAA Eligibility Wrapper (HEW) tool that is used for converting Query files is now available for download via… Read more »