CMS Updates Section 111 NGHP User Guide

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 »

Minor Change at CMS Should Result in Quicker Claim Acceptance

On Monday, September 27, 2021, the Centers for Medicare and Medicaid Services (CMS) announced a minor, yet impactful change to their Section 111 processes.  October 4, 2021, CMS will accept a claim when the MSP effective date is up to three months in the future.  In turn, the CMS system will create an MSP record… Read more »

CMS Town Hall Meeting Addresses PAID Act

On Wednesday, June 23, 2021, the Centers for Medicare and Medicaid Services (CMS), hosted a town hall presentation regarding the PAID Act and its implications to the Section 111 Process.  The transcript of today’s call will be available on the CMS.gov website in roughly 2 weeks. While there were no significant updates or changes based… Read more »

“Soft” Edits Debut Today in Section 111 Reporting

Today marks the first significant update in Section 111 reporting logic in several years.  In November 2020 the Centers for Medicare and Medicaid Services (CMS) announced a new classification of “soft” edits that will take effect today (April 5, 2021).  The information below outlines what “soft” edits are and how they will change the way… Read more »

CMS Announces Section 111 Technical Updates

On Thursday, January 21, 2021 the Centers for Medicare & Medicaid Services (CMS) released an updated Section 111 NGHP User Guide (back-dated to January 11, 2021).  While it contained nothing earth-shattering, there are a few important updates of note. CMS will now accept a claim with an ORM Termination Date that is up to 75… Read more »

PAID Act Becomes Law

This week Medicare updated the announcement to better define the scope of the proposal.