Monthly Archives: October 2010

Obtaining Social Security Numbers for MMSEA Section 111 Reporting

Insurance adjusters throughout the country should already be aware of MMSEA Section 111, which mandates that insurance companies submit electronic reports with information about payments made to Medicare beneficiaries by liability insurers, no-fault insurers, workers’ compensation insurers, and even self-insurers. These reporting requirements only apply to payments to Medicare beneficiaries. But the new rules affect all claims because a threshold question for each and every liability or no-fault claim will be: Is the claimant a Medicare beneficiary? Some claimants may admit that they are Medicare beneficiaries. But for any claimants that deny they are Medicare beneficiaries, insurers have a duty to investigate whether those claimants actually are Medicare beneficiaries. And for any claimants who admit to Medicare beneficiary status but provide inaccurate Medicare Health Insurance Claim Numbers (HICNs), the insurer must determine the correct number. CMS (Centers for Medicare and Medicaid Services) has created an electronic query program for insurance companies to use to determine the Medicare status of beneficiaries. For a successful query, the insurer needs: the claimant’s Social Security Number (or preferably the … Continue reading

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