The Medicare, Medicaid, and SCHIP (State Children’s Health Insurance Program) Extension Act of 2007 (MMSEA) adds new mandatory reporting requirements for group health plans. Many of the HMO and PPO enrollment forms and SUP Welfare Plan forms have not required participants to indicate the social security number of their spouse or dependent children in the past. Current enrollment forms for all medical plans do require the spouse’s social security number.
The SUP Welfare Plan or your group plan may be contacting you for this information in the near future. Please be sure to give this information only to those entities that have a right to the information.
The reporting requirements are due to an increased effort to ensure that individuals will have the opportunity to receive aid through Medicare or Medicaid if their personal situation develops a need for such aid.
It is recommended that you obtain social security numbers for your children also since reporting requirements within the next few years will likely require social security numbers for all enrolled individuals. Be sure to keep this information easily found for your use and secure from anyone else. Privacy laws require that the SUP Welfare Plan does not share personal information with any entity which does not have a right to the information.
Claims for Foreign Bills
Claims for reimbursement of foreign bills must include a translation into English as well as the original billing. Required information for consideration of reimbursement includes the diagnosis, name and address of the provider of services, the patient’s name, the date of service, a description of the service, and the itemized charges.
Active participants who obtain services outside of the USA or their service area must submit their claim to their HMO or PPO Plan. Please contact your HMO or PPO plan if you have any questions.