Medicare Entitlement and Primacy Management – Voluntary Data Sharing Agreement (VDSA)

A Voluntary Data Sharing Agreement is executed by the Centers for Medicare and Medicaid Services and an employer to electronically exchange Medicare and group health plan entitlement information. The employer agrees to share, on a quarterly basis, group health plan entitlement information on employees and their spouses. In exchange, the Center for Medicare and Medicaid Services agrees to provide the employer with Medicare entitlement information for identified Medicare individuals. This enables claims to be paid by the correct payor when first billed.

The government’s Voluntary Data Sharing Agreement permits an employer to exchange data monthly with the Centers for Medicare and Medicaid Services that supports Medicare primacy identification. The frequency of the data exchange under the Voluntary Data Sharing Agreement allows the employer’s retiree health plan to take a secondary position as early as possible for eligible participants. The Voluntary Data Sharing Agreement, after a couple of monthly cycles, also eliminates Medicare Secondary Payer Debts and Overpayment Recoveries because accurate primacy is established prior to medical claims being submitted. Population surveys, the standard tool of other suppliers, allow primacy information to be updated for the retiree population who cooperates usually every one to three years. SSDC’s data exchange services are accurate for 100% of the population every month. The immediacy and accuracy of our process means administrators, medical providers and employers have reduced administrative costs and beneficiary satisfaction is higher as a result of primacy and payment information being correct from the start.

SSDC has been the Centers for Medicare and Medicaid Services recognized data intermediary from the inception of the Voluntary Data Sharing Agreement in 2002 and currently exchanges data on behalf of employers for over 4,000,000 beneficiaries. Our company built and regularly enhances our proprietary data exchange system which allows employers to utilize their own routine data feeds and avoid the high cost of developing and maintaining their own Voluntary Data Sharing Agreement data base, system and staff.

SSDC exchanges data from all of an employer’s health plans and administrators so there are no gaps in information, timing or retiree service, unlike when an employer relies on multiple insurers to perform individual data exchanges. Our company includes a retiree communication plan and a toll-free help line as part of our Medicare Entitlement and Primacy Management services that can be linked with an employer’s overall beneficiary communication program. We know that no massive data exchange is perfect and that any benefit primacy changes are likely to produce questions. Our ombudsman line is staffed by experienced service representatives who are trained in both Medicare and Social Security law, regulations and an employer’s specific benefit plans.

In support of the Medicare Entitlement and Primacy Management data exchange, SSDC offers related services that provide additional savings to the employer and additional service to beneficiaries. These services can be bundled with Medicare Entitlement and Primacy Management services or provided on an ad hoc basis to smaller or targeted populations: