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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.

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ID Title Type Description
01 NGHP Curriculum PDF A printable listing of the courses and their descriptions for the NGHP CBT Curriculum.
02 Acronym List PDF A list of acronyms pertaining to MMSEA Section 111 and their descriptions.
03 NGHP Curriculum Overview PDF 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.
04 NGHP Mandatory Insurer Reporting Overview PDF 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).
05 Responsible Reporting Entity PDF 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 the registration of an entity within a corporate structure and provides examples to help illustrate these rules. This course also clarifies who the RRE is in various situations.
06 Process Overview PDF 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.
07 Section 111 Registration Part I PDF 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.
08 Section 111 Registration Part II PDF The Section 111 Registration Part II course details the final 3 steps of registration and account setup.
09 COBSW – Step 1 – New Registration PDF Registration must be completed on the Section 111 COBSW. This course reviews how to register on the Section 111 COBSW.
10 Frequently Asked Questions – New Registration PDF This course addresses questions relating to the registration process, RRE IDs, Tax Identification Numbers (TINs), Authorized Representatives, subsidiaries, new registration troubleshooting, and registration documentation.
11 COBSW – Step 2 – Account Setup PDF Account setup must be completed on the Section 111 COBSW. This course reviews how to set up an account on the Section 111 COBSW.
12 Frequently Asked Questions – Account Setup PDF 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.
13 Modifying Your Section 111 Registration PDF 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, and changing RRE information.
14 File Format Standards PDF The topics in this course include: file format; header, detail and trailer records; and data formatting standards.
15 Claim Input File Overview PDF This learning module provides an introduction to the Claim Input File, including an overview on reporting requirements, submission timeframes and claim responses.
16 Claim Input File Data Elements PDF 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.
17 ICD Diagnosis Code Requirements Part I PDF 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 Part II explains the transition from ICD-9-CM to ICD-10-CM and explains where a RRE can obtain valid ICD diagnosis codes.
18 ICD Diagnosis Code Requirements Part II PDF This module explains the transition from ICD-9-CM to ICD-10-CM and explains where a RRE can obtain valid ICD diagnosis codes.
19 ICD Requirements FAQ PDF This module addresses Frequently Asked Questions (FAQs) regarding ICD Diagnosis Code reporting for Section 111.
20 TIN Reference File PDF 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; and, address validation.
21 TIN Reference Response File PDF 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.
22 Mandatory Reporting Thresholds PDF 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 to Claimant (TPOC) Amounts. It also reviews the requirements for reporting ORM and TPOC Amounts for liability and worker’s compensation. It ends with threshold reporting examples for liability TPOC Amounts and workers’ compensation ORM.
23 Ongoing Responsibility for Medicals (ORM) PDF 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 discusses the reporting requirements for claims where ORM has been assumed.
24 Total Payment Obligation to Claimant (TPOC) PDF 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.
25 Initial Claim Input File Submission PDF 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.
26 Quarterly Claim Input File Submission PDF 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.
27 Claim Input File Events PDF 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.
28 Claim Input File Reporting Do’s and Don’ts PDF 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 topics: RRE addresses, ICD-9 Diagnosis Codes, Reporting ORM, Identifying an Injured Party, Disposition Code 51, Injured Party Gender, Policy Number, Plan Insurance Type, and Self Insured Type.
29 Reportable Claims PDF 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.
30 Claim Response File PDF This course explains Claim Response File, Disposition Codes, Error Codes, File Level and Threshold Errors, and Compliance Flags.
31 Testing Process PDF This course discusses testing preparation, an overview of the testing process, general testing requirements, and the Section 111 COBSW.
32 Lessons Learned and Best Practices for Section 111 PDF 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 lengths, File Record Counts, and File Submission Dates; as well as other common mistakes related to SFTP Mailboxes, TINs and Office Code/Site IDs, and ICD Diagnosis Codes. Information is also provided on how to obtain beneficiary test data.
33 Query File PDF 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 topics: Query Input File (submission, contents and processing), Query Response File (contents and processing), Query File transmission, translator software, and Query File testing.
34 Beneficiary Lookup PDF 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 results.
35 Data Transmission Method Selection PDF 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 registration.
36 SFTP File Transmission for Section 111 PDF 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 monitor file processing results.
37 Connect:Direct File Transmission for Section 111 PDF 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 results on the Section 111 COBSW.
38 HTTPS Using Section 111 COBSW PDF 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 on a regular basis, and are willing to have someone login to the Section 111 COBSW to upload/download files and monitor the progress during the file transmission. The course concludes with a discussion of monitoring file processing results on the Section 111 COBSW.
39 DDE Using the Section 111 COBSW PDF 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.
40 Switching to or from DDE PDF 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.
41 DDE Screens Overview PDF 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 Claim Listing screen. It explains the fields displayed and the actions that can be performed from this screen.
42 DDE Adding a Claim Report PDF 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 Claimant Representative Information.
43 DDE Resume, Update & Delete Claim Reports PDF 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.
44 DDE Best Practices PDF This module shares best practices to be used by DDE submitters so that they are successful in submitting Section 111 claim reports.
45 COBSW Basic Functions PDF 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.
46 COBSW Account Designee Maintenance PDF 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 Account Designee e-mail invitation.
47 COBSW Account Designee Registration PDF This course reviews the Account Designee user role and registration process. It also reviews login ID and password guidelines.
48 COBSW View/Update RRE Profile Information PDF 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.
49 COBSW Monitor File Processing PDF 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.
50 COBSW Uploading/Downloading Files via HTTPS PDF 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.
51 COBSW Monitor Test File Processing PDF 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.
52 COBSW View Account Activity History PDF 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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