As we previously reported, beginning October 5, 2015, the Commercial Repayment Center (CRC) will handle the recovery of conditional payment claims when CMS is pursuing reimbursement directly from the primary payer. The Benefits Coordination and Recovery Center (BCRC) will still handle the recovery process when CMS is pursuing reimbursement from the beneficiary.
CMS has indicated that the CRC may pursue recovery from the RRE when ORM has been reported under Section 111 or w
On September 17, 2015, CMS held a webinar to discuss the new role of the Commercial Repayment Center (CRC) in the NGHP recovery process. Beginning October 5, 2015, the CRC will handle the recovery of conditional payment claims when Medicare is pursuing reimbursement directly from the primary payer. CMS indicated in the webinar that the CRC will primarily pursue recovery from the primary payer in cases in which ORM has been reported under Section 111 or the primary payer has
CMS issued an alert as a reminder that Responsible Reporting Entities and their agents must report ICD-10-CM diagnosis codes on claim reports with a CMS date of incident on or after October 1, 2015. The apparent intention of this alert is to emphasize that the timing of this reporting requirement has not changed. The full text of the alert can be found here. #CarrAllisonMedicareCompliance #ICD10 #RRE #CMSUpdate
On June 18, 2015, CMS issued an Alert entitled "Modification of Matching Criteria Used When Reporting Partial Social Security Numbers for Liability Insurance (Including Self-Insurance), No Fault Insurance, and Workers’ Compensation." The text of that alert is copied below: New Matching Criteria for Partial SSNs In order to determine if individuals are Medicare beneficiaries, the following information is used: •HICN or SSN •First initial of the first name •First 6 characters