Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: May 25, 2016

Program Area: ACA Financial Appeals (ACA FA)

Question: May issuers with fewer than five (5) Health Insurance Oversight System (HIOS) IDs use the Overlapping Claims Job Aid when reporting detailed research on overlapping claims?

Answer: Yes, any issuer of any size may use either method of reporting detailed information on overlapping claims. Since issuers must complete the entire web form in one (1) session for all applicable HIOS IDs and enrollees, the Centers for Medicare & Medicaid Services (CMS) recommends the use of the Overlapping Claims Job Aid to any issuers with large numbers of affected enrollees.

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