NGHP Training Material
NGHP Training Material
A curriculum of computer-based training (CBT) courses related to Section 111 Non-Group Health Plan (NGHP) Mandatory Insurer Reporting has been developed for NGHP responsible reporting entities (RREs). These courses provide in-depth training on reporting requirements documented in the NGHP User Guide and also include courses on registration and use of the Section 111 Coordination of Benefits Secure Website (COBSW). The CBTs require no registration.
Please see the Non-Group Health Plan Curriculum for a complete listing of the courses, their descriptions and course lengths. You can access the curriculum document and the CBTs from the Dynamic List on this page. If you have any questions or feedback on this material, please click the Training Feedback link found in the Related Links section below.
| ID | Title | Type | Description |
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NGHP Curriculum
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PDF
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A printable listing of the courses and their descriptions for the NGHP CBT Curriculum.
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Acronym List
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PDF
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A list of acronyms pertaining to MMSEA Section 111 and their descriptions.
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NGHP Curriculum Overview
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PDF
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The Centers for Medicare & Medicaid Services (CMS) have provided a curriculum of CBT courses to supplement the NGHP User Guide. This course reviews the NGHP CBTs that are available.
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NGHP Mandatory Insurer Reporting Overview
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PDF
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This learning module reviews information that is included in the Quick Reference Guide For NGHP Insurers (The What, Why and How of MMSEA Section 111 Reporting).
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Responsible Reporting Entity
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PDF
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This course provides information regarding who/what entity is an MMSEA Section 111 Responsible Reporting Entity (RRE) for Liability Insurance (Including Self-Insurance), No-Fault Insurance, and Workers' Compensation. It reviews the rules that exist for th...
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Process Overview
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PDF
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The topics in this course include: purpose of the data exchange, data exchange details, file types, the Section 111 COB Secure Web site (COBSW), and the Data Use Agreement. This course also reviews options for customer service and reporting assistance.
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Section 111 Registration Part I
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PDF
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RREs will register on the Section 111 COBSW. The Section 111 Registration Part I course details the first two steps of registration and account setup.
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Section 111 Registration Part II
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PDF
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The Section 111 Registration Part II course details the final 3 steps of registration and account setup.
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COBSW - Step 1 - New Registration
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PDF
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Registration must be completed on the Section 111 COBSW. This course reviews how to register on the Section 111 COBSW.
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Frequently Asked Questions - New Registration
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PDF
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This course addresses questions relating to the registration process, RRE IDs, Tax Identification Numbers (TINs), Authorized Representatives, subsidiaries, new registration troubleshooting, and registration documentation.
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COBSW - Step 2 - Account Setup
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PDF
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Account setup must be completed on the Section 111 COBSW. This course reviews how to set up an account on the Section 111 COBSW.
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Frequently Asked Questions - Account Setup
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PDF
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This course addresses questions relating to the account setup process, Section 111 COBSW user roles, data transmission methods, Section 111 COBSW login and password, and account setup troubleshooting.
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Modifying Your Section 111 Registration
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PDF
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This course provides information regarding the steps RREs must take if changes occur after their initial Section 111 registration is completed, including: abandoning RRE IDs, ceasing use of an RRE ID, transitioning of reporting, changing reporting agents,...
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File Format Standards
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PDF
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The topics in this course include: file format; header, detail and trailer records; and data formatting standards.
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Claim Input File Overview
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PDF
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This learning module provides an introduction to the Claim Input File, including an overview on reporting requirements, submission timeframes and claim responses.
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Claim Input File Data Elements
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PDF
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This module explains the Claim Input File data format. It describes the header, detail, auxiliary and trailer records, and provides an overview on editing that will be performed on the submitted data.
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ICD Diagnosis Code Requirements Part I
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PDF
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This module explains the importance of ICD diagnosis codes for Section 111 reporting, describes what these codes are used for, clarifies the ICD diagnosis code reporting and explains how to derive an ICD diagnosis code. ICD Diagnosis Code Requirements Par...
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ICD Diagnosis Code Requirements Part II
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PDF
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This module explains the transition from ICD-9-CM to ICD-10-CM and explains where a RRE can obtain valid ICD diagnosis codes.
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ICD Requirements FAQ
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PDF
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This module addresses Frequently Asked Questions (FAQs) regarding ICD Diagnosis Code reporting for Section 111.
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TIN Reference File
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PDF
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This learning module explains the TIN Reference File contents and submission. It explains the use of the Office Code/Site ID field and provides examples of when this field might be used. It also reviews TIN Reference File errors; editing; basic validation...
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TIN Reference Response File
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PDF
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This learning module explains the TIN Reference Response File; TIN Validation; processing of the Claim Input File once the TIN Reference Response File has been created; and, transmission of the TIN Reference Response File.
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Mandatory Reporting Thresholds
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PDF
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This learning module explains the reporting threshold requirements which have been established for Section 111 reporting. It reviews the requirements for reporting No-Fault Insurance Ongoing Responsibility for Medicals (ORM) and Total Payment Obligation t...
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Ongoing Responsibility for Medicals (ORM)
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PDF
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This learning module begins by defining the term 'ongoing' and providing information on some of the fields used in reporting ORM: ORM Indicator, ORM Termination Date and ICD-9 diagnosis codes. It also clarifies what is meant by assumption of ORM and discu...
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Total Payment Obligation to Claimant (TPOC)
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PDF
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This CBT explains the term TPOC, provides clarification on each TPOC field (TPOC Date, TPOC Amount and Funding Delayed Beyond TPOC Start Date), describes how to submit a TPOC, and clarifies how to correct or remove an erroneous TPOC.
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Initial Claim Input File Submission
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PDF
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This module discusses the reporting requirements for the Initial Claim Input File, including retroactive reporting requirements. It reviews the file submission timeframes and provides Claim Input File submittal examples.
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Quarterly Claim Input File Submission
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PDF
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This module explains what is to be reported on the quarterly Claim Input File. It describes the add, delete, and update transactions and when you would use each, and explains what to do when you don't have any Claim Detail Records or changes to report.
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Claim Input File Events
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PDF
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This module provides a high-level overview on what is to be reported on the Claim Input File and gives examples of how to submit Claim Input File Detail Records for various situations.
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Claim Input File Reporting Do's and Don'ts
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PDF
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This module provides some helpful reminders for RREs to consider when submitting Claim Input Files or providing claim information via Direct Data Entry (DDE). It reviews when delete transactions should be used. It also provides reminders on the following ...
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Reportable Claims
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PDF
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This learning module reviews the Section 111 claim reporting requirements. It explains when claims are reportable and provides information regarding circumstances that are not reportable under Section 111.
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Claim Response File
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PDF
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This course explains Claim Response File, Disposition Codes, Error Codes, File Level and Threshold Errors, and Compliance Flags.
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Testing Process
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PDF
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This course discusses testing preparation, an overview of the testing process, general testing requirements, and the Section 111 COBSW.
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Lessons Learned and Best Practices for Section 111
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PDF
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This course shares lessons learned from NGHP reporting to date. It reviews the following information to help improve the results of your testing: communicating with your Electronic Data Interchange Representative; Severe Errors caused by invalid record le...
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Query File
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PDF
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The Query File course reviews the Section 111 reporting requirements and the purpose of the Query File. It includes an overview of the Query Input File and provides the Section 111 data flow when the Query File is used. It also includes the following topi...
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Beneficiary Lookup
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PDF
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This module explains the Beneficiary Lookup action and who can use it. It reviews the query request limit associated with the Beneficiary Lookup action. It shows how to use the Beneficiary Lookup action and explains the matching criteria and response resu...
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Data Transmission Method Selection
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PDF
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This course provides a high-level overview of the data transmission methods available for Section 111 and items to consider when making your selection. It reviews the profile report and explains how to change your data transmission method after registrati...
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SFTP File Transmission for Section 111
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PDF
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This course provides a high-level overview of the Section 111 COBSW. It reviews the procedures for transmitting files using Secure File Transfer Protocol (SFTP) for Section 111. The course concludes with a discussion of how to use the Section 111 COBSW to...
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Connect:Direct File Transmission for Section 111
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PDF
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This course provides an overview on Connect:Direct. It reviews the information required during account setup, provides an overview on the profile report, explains the naming convention used on Connect:Direct input files and explains file processing result...
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HTTPS Using Section 111 COBSW
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PDF
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This course provides a high-level overview on transmitting files via Hypertext Transfer Protocol over Secure Socket Layer (HTTPS) using the Section 111 COBSW. This file transmission method is recommended for those RREs that will not be sending big files o...
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DDE Using the Section 111 COBSW
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PDF
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This module provides an overview on NGHP DDE, explains the reporting requirements and reviews how an NGHP RRE can get started with this reporting method.
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Switching to or from DDE
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PDF
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This course explains the process an NGHP RRE must follow when switching to DDE from a file submission method, explains how an NGHP RRE can switch to a file submission method from DDE, and includes general information regarding these methods.
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DDE Screens Overview
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PDF
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This module provides an overview on how to login to the Section 111 COBSW, clarifies what affects the Transactions Remaining Count, and provides an overview on the screens used to enter a DDE claim report. The second part of this course focuses on the DDE...
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DDE Adding a Claim Report
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PDF
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This module explains how to enter a DDE New Claim report by completing information on the New Claim screens: Injured Party Information, Injury Information, ORM and TPOC Information, Insurance Information, Representative Information, and Claimant and Claim...
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DDE Resume, Update & Delete Claim Reports
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PDF
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This module begins with an overview of the Claim Listing page. It explains when and how to resume the DDE claim submission process and clarifies when and how to submit updates and deletes to DDE claim reports.
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DDE Best Practices
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PDF
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This module shares best practices to be used by DDE submitters so that they are successful in submitting Section 111 claim reports.
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COBSW Basic Functions
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PDF
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This course provides an overview of the Section 111 COBSW Login/Logout procedures and reviews some of the basic functions available to RREs from the home page of the Section 111 COBSW.
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COBSW Account Designee Maintenance
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PDF
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To assist with RRE account management and data file processing, the Account Manager may designate one or more Account Designees to an RRE. This course covers how to add/delete an Account Designee, edit Account Designee information, and regenerate an Accou...
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COBSW Account Designee Registration
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PDF
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This course reviews the Account Designee user role and registration process. It also reviews login ID and password guidelines.
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COBSW View/Update RRE Profile Information
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PDF
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This course reviews the importance of RRE profile information and how to view/update this information. It also describes the contents of the RRE Information Summary page.
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COBSW Monitor File Processing
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PDF
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To assist with account management and data file processing, RREs have the ability to monitor file processing and history. This course reviews the file processing pages that RREs will use while monitoring production file processing.
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COBSW Uploading/Downloading Files via HTTPS
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PDF
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The Uploading/Downloading Files via HTTPS course reviews file upload guidelines, how to upload input files, threshold and severe file submission errors, and how to download response files.
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COBSW Monitor Test File Processing
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PDF
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This course reviews the testing process, reporting Agent testing, threshold and severe file submission errors, and how to view test file results on the Section 111 COBSW.
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COBSW View Account Activity History
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PDF
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To assist with account management, RREs can review the activity performed for an RRE ID account on the Account Activity page. This course shows how to navigate to, and review the content of, the Account Activity page.
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Page Last Modified:
09/06/2023 04:57 PM