Allegro MIR Reporting

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Allegro MIR Reporting

MIR Overview

Originally Legislated in 1980, the Medicare Secondary Payer Act established that Medicare will be a secondary payer to eligible recipients if claims can be paid by another primary payer. Primary payers are Workers’ Compensation, Health, Auto No-Fault and Liability providers as well as Self-Insured organizations. In December, 2007, the SCHIP (State Children Health Insurance Program) Extension Act was enacted which requires all primary payers to verify Medicare beneficiary status on all claims on a quarterly basis. In addition, once a claim has been established as a Medicare beneficiary, quarterly claim reporting is also required.

The Centers for Medicare & Medicaid Services (CMS)'s new mandatory insurer reporting (MIR) requirement is quickly becoming a top priority for insurers and other organizations serving the insurance industry. Whether referred to as SCHIP, MMSEA, Section 111 or MIR, the new requirement imposes an important deadline that now looms on the horizon for responsible reporting entities (RREs) and their vendors.

Originally, live production reporting was set to begin during the fourth quarter of 2009. However, in an alert issued by CMS in March 2009, the deadline was pushed back one quarter to the first quarter of 2010. The March alert also extended the testing period until December 31, 2009, though the start date for the testing period remained at July 1, 2009.

The stiff penalty for noncompliance has generated a significant buzz within the insurance industry. RREs that fail to comply with the MIR requirements are subject to a civil money penalty of $1,000 for each day of noncompliance for each individual for which the information should have been submitted.

As an industry leader in Property & Casualty and Workers’ Compensation technology, @Global is the perfect choice for your needs and will help manage the processes required as a result of the new legislation and reporting requirements. @Global provides technology tools and services to ensure accuracy and compliance with automated Medicare beneficiary checking (Social Security Verifications-SSV) and Mandatory Insurance Reporting. Allegro MIR is a user-friendly application that facilitates MIR for insurers, self-insured organizations and other responsible reporting entities (RREs).

Allegro MIR Self Service

Allegro MIR Self Service is a web-based application designed for Self-Insured/Self Administered Employers or small Required Reporting Entities (RRE) with low volumes of monthly claims and do not require the full integration of an enterprise claims system. Whether you utilize a small claims database, Excel spreadsheets or manual paper files, the Allegro MIR Self Service is the tool for you.

The simple, front end data input utility will allow you to manually enter the data as a single claim, or upload an .xls or .csv file of multiple claims. The required fields will be displayed and a file template can be downloaded to help walk you through the process.

Features and Functions

Allegro MIR Self-Service contains the functions and features needed to successfully prepare and transmit the required information to Medicare’s Coordination of Benefits Contractor (COBC). The list below documents some of Allegro MIR’s key attributes.

Query File Menu (to support Medicare eligibility verification activities)

Import/upload claimant info, including SSN from an Excel spreadsheet.
Ability to manually add claim information
View/edit claimant info
Submit Query Input file (to COBC)
Import Query Response file (from COBC)
- If data errors exists from the source file, alert flags will display and allow correction and resubmission of correct data
Export/download claimant eligibility information and data

Claim Reporting Menu

Import/upload Medicare eligible claimant information from an Excel spreadsheet
Ability to manually add claim information
View/edit claim info
Submit Claim Input file (to COBC)
Import Claim Response file (from COBC)
View/edit claim info based on CMS response
- If data errors exists from the source file, alert flags will display and allow correction and resubmission of correct data
Re-submit Claim Input file (to COBC)
Export claim information as an .xls, .csv or .xml format

File Tracking

All submission and response files are date stamped and tracked
Status monitoring for all file submissions

Historical Reports

Easy access to historical reports

Demostration

Product demonstrations may be scheduled by contacting @Global at 800-419-4449 ext. 15 or info@atglobal.com.

Plug-In

Allegro MIR Plug-In is designed for insurers, third party administrators and self-insured organizations with in-house Claims Management Systems that manage heavier claim volume and multiple Required Reporting Entities (RRE’s) or clients. Allegro MIR offers RREs a simple and effective means of complying with MIR requirements. As a browser-based application, Allegro MIR is easy to set up and easy to use. Claim information is easily imported from your existing Claim Management System. Allegro MIR’s field edits validate required information prior to transmitting reports to Medicare’s Coordination of Benefits Contractor (COBC). An integrated audit trail and system alerts ensure the integrity of the reporting process.

@Global will work with you to configure direct mapping of current fields within your database.