PMSI Acheives High Mandatory Insurer Reporting Submission Approval Rating For Clients

Share Article

The Industry Leader in Medicare Secondary Payer Compliance Ensures Accurate and Flexible Reporting

News Image
The high acceptance rate by CMS demonstrates PMSI’s regulatory knowledge and technical expertise, and reinforces our belief that MedicareConnect is one of the most comprehensive MMSEA Section 111 compliance tools available

PMSI, one of the nation’s largest and most experienced companies focused on workers’ compensation and liability markets, today announced a 95% acceptance rate on Mandatory Insurer Reporting (MIR) submissions through its MedicareConnectSM solution. MedicareConnect is PMSI’s comprehensive platform for MIR compliance requirements related to the Medicare, Medicaid and SCHIP Extension Act (MMSEA) of 2007.

The reporting required by the Centers for Medicare & Medicaid Services (CMS) to fulfill MIR requirements went live on January 1, 2011. The processes to achieve full compliance are complex and require extensive technology, data scrubbing and timely submission for entities that must report claims. Many reporting entities have encountered difficulties, including significant issues with data validation—resulting in either not reporting eligible claims or unnecessarily reporting ineligible claims to CMS. These data issues can increase risk for payers, as data reported with errors can result in temporary suspension of reporting with CMS, increasing the risk of non-compliance penalties.

“To date, PMSI has queried and/or reported over 1 million claims. The high acceptance rate by CMS demonstrates PMSI’s regulatory knowledge and technical expertise, and reinforces our belief that MedicareConnect is one of the most comprehensive MMSEA Section 111 compliance tools available,” says Pat Sullivan, PMSI’s President of Settlement Solutions. “Mandatory Insurer Reporting is one of the most critical issues we face in the industry today and PMSI has addressed these issues with a robust reporting solution that ensures compliance while minimizing the impact to client workflows and processes.”

The MedicareConnect system contains an advanced library of MMSEA Section 111 regulatory business rules that are consistently reviewed and maintained by PMSI’s regulatory specialists. MedicareConnect offers flexible options to meet the needs of Responsible Reporting Entities (RREs) of any size. Significant benefits of MedicareConnect include:

  • Data transmission options for data feed, manual entry or hybrid
  • Integrated MMSEA Section 111 regulatory business rules for data validation
  • Ability to aggregate data from multiple data providers
  • Quick assessment of claim status
  • Detailed reports that facilitate work queue management
  • Keyword search for ICD-9 and e-codes

“PMSI’s clients have appreciated the proven results of our MedicareConnect solution and its key features to offer workflow efficiencies and data intelligence,” says James Molloy, PMSI’s Vice President of Client Services. “We understand that compliance is critical and our dedicated regulatory and information technology teams have responded rapidly to changes in MIR requirements and have protected the interest of our clients.”

About PMSI
Founded in 1976, PMSI is a leader in developing solutions to control the growth of medical costs in workers’ compensation. As one of the nation’s largest and most experienced companies focused solely on workers’ compensation, we deliver proven solutions for cost containment across the claims lifecycle. PMSI’s Pharmacy, Medical Services and Equipment, and Settlement Solutions products deliver quantifiable results and improve the quality of care for injured workers. We provide our customers with the innovation, focus, expertise, analytics and technology needed to successfully deliver workers’ compensation benefits. For more information, visit http://www.pmsionline.com or call 877.ASK.PMSI.

PMSI Contact:
Shelia Chapman
Vice President, Marketing
877.ASK.PMSI
shelia(dot)chapman(at)pmsionline(dot)com

# # #

Share article on social media or email:

View article via:

Pdf Print

Contact Author

Shelia Chapman
PMSI, Inc.
877.ASK.PMSI 2731
Email >
Visit website