Specifications include, but are not limited to:Workforce Safety and Insurance (WSI) is soliciting proposals for a vendor to perform Medicare Section 111 reporting to ensure that WSI is compliant with all reporting regulations and requirements. The goal of this project is to assist WSI with the Section 111 quarterly reporting to Medicare and ensure that WSI is compliant with the reporting requirements. WSI currently acts as its own Reporting Agent. Vendor must have the ability to: Receive data in a standard data file format from WSI; Capture and maintain all history of reporting a claim that includes the dates of and data from: Query files Query response files Claims input files Medicare’s response files Create and maintain a trail of reporting history for audit process. Upload WSI’s prior Claims Input Files and Medicare’s Response Files. Query every claimant until Medicare eligibility is confirmed or until claim closed. Ensure claims data for compliance with CMS eligibility and Section 111 reporting requirements. Provide notifications of potential report ability issues, TPOCs, ORMS. Provide notification of missing, incomplete, or inaccurate data before submitting to Medicare. Quickly respond to changing CMS requirements. Assist WSI in responding to any error codes or flags in the CMS Response File. 3.02
