In further implementation of the SMART Act, on January 5th, 2015 CMS released the latest version of the MMSEA Section 111 NGHP User Guide. The changes were expected, and are welcomed. The 2 major changes to the user guide are outlined below:
1) CMS will now accept 5 digit SSN’s on submitted records. RREs that submit query and claim input files may now enter SSN’s with 4 leading spaces. DDE clients only need to type in the last 5 and do not need to enter the leading spaces. To accommodate this change CMS has updated the Disposition Codes to include DP (used for identifying duplicates), Disposition Code 51 has been slightly modified, and the beneficiary matching logic has been modified. Taken directly from the user guide:
a. The beneficiary matching logic has been changed. First, an exact match on the HICN or SSN entered (either the last 5 digits or full 9 digits) must be found. Then, at least three of the four remaining data elements (listed below) must be exactly matched to the individual: First initial of the first name First six characters of the last name Date of Birth (DOB) Gender
View the Technical Alert regarding Reporting Partial SSNs:
Please contact us directly if you have additional questions.