Providers: Good news! We can now receive electronic claims using Optum’s iEDI Clearinghouse using our payer id# 67788. Please CLICK HERE for more information.

Section 111 Reporting

Section 111 Reporting: Ensuring compliance, reducing spend.

The purpose of Section 111 reporting is to enable Medicare to correctly pay for the health insurance benefits of Medicare beneficiaries by determining primary versus secondary payer responsibility. Section 111 authorizes CMS and GHP RREs to electronically exchange health insurance benefit entitlement information.

NAHGA has partnered with a unique service provider with a comprehensive Section 111 Reporting Platform for reporting workers’ compensation, liability, and no-fault claims to CMS. Our partnership helps overcome Medicare Secondary Payer (MSP) compliance process limitations.  We also offer an additional service for conditional payment and lien resolution leveraging Verisk’s CP Link process.  This fully integrated MSP compliance system saves time and money and takes a more active role in defending against inappropriate recovery claims. This system and our partnership with industry leader, Verisk - ISO Claims Partners ensure the following benefits:

  • Provides full integration
  • Ensures complete compliance
  • Provides unprecedented insight and visibility
  • Saves time in the process and conserves resources
  • Maximizes cost mitigation and exposure-reducing opportunities