Delray Beach, FL – The Centers for Medicare and Medicaid Services (CMS) proposed stiff penalties surrounding Section 111 Medicare Mandatory reporting earlier this year. When penalties become effective, failing to accurately report acceptance and/or termination of ongoing responsibility for medicals (ORM) and total payment obligation to the claimant (TPOC) could cost workers’ compensation payers up to $1,000 per day per claimant.
In addition to holding a webinar to help clients effectively manage Medicare Secondary Payer (MSP) compliance and avoid penalties, Tower MSA Partners has launched its S111 Management Dashboard to provide 24/7 data and reporting oversight for all aspects of the reporting process.
Typically, workers’ compensation and liability payers have limited access to claims history via their Section 111 providers’ reporting systems. “Account managers may receive compliance error reports,” said Tower CEO Rita Wilson, “but they cannot quickly verify compliance accuracy. Also, few systems remind RREs to update ORM termination dates when claims are settled.” With Tower’s S111 Dashboard, clients have full claims data feed visibility, and can run reports, correct errors, and immediately resolve compliance issues.
“The dashboard is intuitive and simple to use,” said Todd Venneri, Business Intelligence Project Manager for BETA Healthcare Group, who tested its features. “The ability to quickly access and verify claim information is invaluable.”
The dashboard comes with major upgrades to Tower’s client portal and MSP Automation Suite that seamlessly manages S111 reporting, conditional payments, MSA triage, clinical and legal interventions, MSA preparation and CMS submission activities through settlement and closure. Built on MSP compliance best practices, the system features a multi-field, data pre-validation file that flags areas CMS would edit and sends clients missing data points or errors to address before eligibility files transmit to CMS.
Tower’s proprietary software platform already incorporated all edits in S111 manuals and updates ICD-9 and ICD-10 codes as CMS publishes them. In addition, Tower recently added 24/7 cybersecurity oversight protection to its entire network platform with a service that proactively searches for data breaches and other security risks.
Source: Tower MSA/King Knight