On October 1, 2018, CMS released an updated Non Group Health Plan (NGHP) User Guide, version number 5.4.
Article by Rafael Gonzalez, Esq. Vice President, Strategic Solutions Over the last couple of weeks, a study prepared for The Casualty Actuarial Society, which was the source of a presentation at the CAS Centennial Celebration and Annual Meeting, in New York, NY, delivered on November 12, 2014, has been getting a lot of attention. The … Read moreCasualty Actuarial Study Finds Medicare Mandatory Reporting Requirements May Cause Modest Loss Increases in Workers Compensation and Liability Claims
On July 1, 2015, CMS published an announcement on its upcoming transition of Non-Group Health Plan recovery workload from the Benefits Coordination & Recovery Center to the Commercial Repayment Center. As part of the continuing efforts to improve the Coordination of Benefits & Recovery (COB&R) program and claims payment accuracy in Medicare Secondary Payer (MSP) … Read moreCMS Announces Switch on NGHP Conditional Payment Recovery from BCRC to CRC and Use of ICD-9 and ICD-10 to Determine Payment of Medical Bills
CMS has released an alert to notify all users that they have modified the matching criteria for queries where the full Social Security Number could not be obtained and a five-digit SSN was provided. This change, which is effective immediately, fixes an issue where false beneficiary matches were made when the partial SSN and only three … Read moreModification of Query Matching Criteria for Partial SSNs