Section 111 NGHP User Guide for Claim Input File

This guide provides detailed instructions for reporting claims under Section 111 of the NGHP. It outlines the requirements for submitting Claim Input Files, including the reporting of ongoing responsibility for medicals (ORM) for various types of insurance such as no-fault, liability, and workers' compensation. The document specifies the necessary data fields, such as the ORM Indicator and ICD Diagnosis Codes, and emphasizes the importance of accurate data submission to avoid errors like disposition code '51'. It also includes guidelines for correcting and deleting transactions, ensuring that RREs validate beneficiary information, and the necessity of monitoring injured parties' Medicare coverage status. The guide stresses the need for compliance with data standards to facilitate successful claims processing and minimize delays in Medicare record posting. Overall, it serves as an essential resource for RREs to navigate the complexities of claim reporting effectively.