Mandatory Medicare Reporting
Section 111 of the Medicare, Medicaid and SCHIP Extension ACT (MMSEA) is a new federal law that requires the reporting to CMS of specific information about Medicare beneficiaries who have other group coverage. This reporting is to assist CMS in properly coordinating payment of benefits among plans so that your claims are paid promptly and correctly.
It is important that you read the CMS form in its entirety, complete each Section of the form and sign and return the form to Allied Benefit Systems, Inc.
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Medicare Forms
Email completed CMS Forms to:
AlliedEligibility@alliedbenefit.com
Subject: CMS SSN Form
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Fax completed CMS Forms to Allied at: 312-906-8879
Attention: Eligibility Department
Subject: CMS SSN Form
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