The Centers for Medicare/Medicaid Services (CMS) requires their interests be protected prior to any settlement of the medical portion of a claim for qualified individuals. CMS legislation has expanded the definition of the administrative requirements. The legislation requires claims with the potential to be covered under the CMS regulations must be reported to the Coordination of Benefits Contractor (COBC) either directly by the parties at risk or by their 'agent'. Penalties for noncompliance are $1,000 per claim, per day.
Medicare Spotlight
Medicare Legislation
Learn more about the new reporting requirements.
Customer Overview
CorVel helps our clients comply with CMS reporting legislation. As an assigned agent, CorVel provides services for Responsible Reporting Entities (RRE) such as insurers, third party administrators and employers. As an experienced information processing provider, CorVel electronically submits files to CMS in compliance with timelines and reporting requirements.
Services
- Assistance with RRE registration
- EDI setup and testing with CMS
- Initial claim reporting and subsequent quarterly reporting
- Claims data clean-up and modifications
- Verification and monitoring of Medicare eligibility
Benefits
- Solutions for CMS reporting requirements
- Minimize programming efforts and system support
- Secure data transmissions ensures HIPAA and PHI compliance
- CorVel has a long lasting relationship with CMS
- National team of compliance experts
