Essential Insurer Reporting (MIR)

//Essential Insurer Reporting (MIR)
Essential Insurer Reporting (MIR)2017-03-30T14:54:10+00:00

Florida-based CompEx MSA manages MIR documentation for employer and insurer clients across the United States. Our comprehensive MIR practice includes all reporting elements that are required by Section 111 of the Medicare, Medicaid and SCHIP Extension Act (MMSEA – 42 U.S.C. §1395y(b)(7)).
Since 2007, when the MMSEA was enacted, the Centers for Medicare and Medicaid (CMS) have required reports about payments made to Medicare recipients by health insurers under group health plans (GHP) or by third-party insurance carriers (non-group health plans, or NGHP) for injuries caused on the job or through by the actions of another (either in a liability or a no-fault case). The provisions for these insurance payers care are found at 42 U.S.C. 1395y(b)(8).

Full Service Compliance Reporting

CompEx MSA ensures full compliance with all reporting standards and requirements of both the MMSEA and the Mandatory Secondary Payer (MSP) Act, including:

  • Accurate registration and appropriate formatting of the account on the Coordination of Benefits Secure Website (COBSW);

  • Identification of all Responsible Reporting Entities (RRE’s);

  • Identification of active and inactive covered individuals;

  • Identification of Small Employer Exceptions (SEE’s);

  • Quarterly MSP file submission updates;

  • Processing MSP response files;

  • Processing of Non-MSP requirements;

  • Facilitation of Codes, including True-Out-Of-Pocket (TrOOP), RxBIN and PCN codes;

  • RDA Retiree files submissions;

  • Testing requirements, and much more.

Using Secure and Safe Technology

claims management professional. CompEx MSA experts have the electronic reporting systems in place and deep comprehension of the rules and regulations to ensure safe and effective reporting, including:

  • Secure and safe digital file transfers;

  • Customizable data integration with any available claims system;

  • Analysis of queries, reporting and conditional payment concerns;

  • Audit Trails;, and

  • Easy to understand reports.

At CompEx MSA, our professionals ensure employers and insurers are in compliance with applicable Medicare laws when their employees or insureds are injured.