Medicare Secondary Payer Reporting Requirements: The Critical Role of Automated Controls and Continuous Monitoring


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Source: Infogix
Date: October 2010
Type: White Paper
Rating: (0)

Overview: Important Points: • Medicare Secondary Payer Act mandates insurance organizations to submit a report when a Medicare eligible beneficiary’s claim is fully or partially resolved during the applicable reporting period. • Lack of reporting compliance may result in fines as high as $1,000 per day for each individual for whom information should have been reported. • Insurance organizations continue to experience challenges to ensure the accuracy and completeness of reports due to the presence of multiple claims systems on multiple platforms and data conversion requirements. • Automated Information Controls eliminate information risks present in the Medicare Reporting process. Continuous monitoring of the reporting process, information controls and exceptions enables insurance organizations to submit required reports with confidence.

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