Rising leverages data integration efficiencies, advanced compliance reporting technologies, and precise clinical coding logic to deliver an automated Section 111 solution that significantly reduces payers’ administrative burden and liability.

Accurate, Compliant & Efficient Reporting

As an experienced reporting agent, Rising helps payers comply with Section 111 of the Medicare, Medicaid, and SCHIP Extension Act (MMSEA). Section 111 reporting is used to ensure Medicare pays appropriately for Medicare beneficiaries’ covered treatment. Accurate reporting is essential to protect the financial interests of all parties when an injury has occurred – the injury claim payer, Medicare, and the beneficiary.

Our comprehensive reporting decreases payer liability for:

  • Excess recovery costs
  • Fines
  • Potential litigation

Granular-Level Diagnosis Codes Prevent Over Reporting

Many Section 111 reporting solutions use broad-based codes that can result in over reporting, whereby high-level diagnosis codes are submitted that include a body part(s) not relevant to the specific injury. This can create complications for beneficiaries down the road if Medicare rejects payment due to misreporting.

Leveraging our vast medical bill review database and clinical coding logic, Rising alleviates this common problem by submitting Section 111 reporting that uses precise diagnosis codes to reflect injuries at their most granular level.

System Integration Reduces Administrative Burden & Enhances Data Integrity

Rising’s automated compliance reporting protocols can support data submission for one or multiple Responsible Reporting Entities (RREs). Using a single, integrated system feed with each customer, we pre-populate our reporting software with claim and beneficiary data to eliminate manual data entry processes by claims professionals. Our automated solution reduces administrative burden, verifies Medicare eligibility, and improves overall quality of reporting.

Flexibility to Choose Full-Service or Leased Software Option 

Rising offers both a full-service, fully integrated option for customers who want to outsource the entire reporting solution or a leased software option for customers who want to perform self-service reporting using our web-based platform. Additionally, Rising’s Section 111 reporting can be purchased individually or bundled together with our other Medicare compliance and/or managed care services. Talk to us about your Section 111 reporting needs and we’ll recommend the best solution for your organization to achieve compliance and cost savings. For more information, contact info@risingms.com.

MMSEA Section 111 Mandatory Insurer Reporting: