CMS Releases Updated Reporting and Recovery Thresholds with News on TPOCs

The Centers for Medicare and Medicaid Services (CMS) has released its latest alert regarding its low-dollar reporting and recovery thresholds pertaining to liability (including self-insurance), workers’ compensation, and no-fault settlements, judgments, awards, or other payments (settlements). CMS’s December 12, 2016, alert, Change in Reporting Thresholds for Certain Liability Insurance, No-Fault Insurance, and Workers’ Compensation Settlements, […]

Should You Purchase MSA Liability Insurance?

It’s estimated that the number of Medicare beneficiaries will reach 80 million by 2030. When it comes to Medicare Secondary Payer (MSP) compliance, enforcement will likely increase as the number of beneficiaries grows and Medicare’s budget becomes pinched. Insurers need to start planning now for the increased compliance burdens they may face. So, should you […]

Deep Dive: Clinical Trials and Section 111 Reporting

ISO Claims Partners is dedicated to demystifying Section 111. Today I’d like to take a deep dive into one reporting trigger of Ongoing Responsibility for Medicals (ORM) by exploring clinical trials. Created by CMS specifically for Section 111 reporting, ORM is the responsibility “presently assumed” to pay for medical treatment related to an accident or […]

Preparing for ICD-10: Are You Ready?

For the past year, it’s been difficult to overlook the numerous reminders from the Centers for Medicare and Medicaid Services (CMS) regarding the upcoming transition from ICD-9 to ICD-10. The change is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA) and plays a critical role for our clients in the area […]

Auditing the Auditor: What Every Company Should Know

With the ever-present threat of a CMS (Centers for Medicare and Medicaid Services) assessment of Section 111 reporting penalties looming on the horizon, many Responsible Reporting Entities (RREs) have turned to independent Section 111 reporting audits. A Medicare compliance audit is designed to assess the RRE’s reporting system and processes to ensure they’re compliant with […]

Medicare Conditional Payment Compliance: Myth vs. Fact

The statutes and regulations that govern Medicare have been referred to by courts as “the most completely impenetrable texts within human experience.” With the complex nature of Medicare compliance comes the resulting confusion. Don’t fall victim to these Medicare Secondary Payer (MSP) misconceptions: Myth #1: I’m an insurance carrier so I don’t have to worry […]