ISO Claims Partners | Medicare Compliance and Claims Resolution Services

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About ISO Claims Partners

ISO Claims Partners provides Medicare compliance and claims resolution services to many of the largest property/casualty insurance companies, as well as self-insured companies and third-party administrators. The services help our clients meet their obligations under state and federal laws — while also reducing claim costs, expediting settlements, and improving efficiency.

We provide tools to help you with:

  • Medicare conditional payments
  • Section 111 reporting
  • Medicare Set-Asides

We also provide protocol design and settlement consultation services to help your organization resolve claims quickly and efficiently.

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ISO Claims Partners
400 Riverpark Drive, Suite 400
North Reading, MA 01864
Phone: 1-866-630-2772
E-mail:
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Products and services to help with:

Predictive Analytics

WC Navigator®
The only predictive analytics solution to incorporate industry data. WC Navigator® predicts claims severity throughout the life of a claim to inform your claims process and improve outcomes.

Liability Navigator™
A comprehensive analytics solution that enables claims handlers to apply best practices in the investigation and resolution of liability and injury claims. Liability NavigatorTM assists with determining liability, identifying subrogation recovery opportunities, and properly evaluating and negotiating claims while improving claims handling consistency.

Case in Point
The newest enhancement to the Navigator platform provides adjusters with vital claims intelligence and decision support to improve insight at critical points in the claim life cycle. Case in Point delivers an instantaneous analysis of claim attributes from historical information.

Medicare Conditional Payments

CP Link™
The most cost-effective and streamlined way to handle Medicare conditional payments

Conditional Payment Services
Investigation, consultation, and compliance services to help you challenge and reduce Medicare's demands for reimbursement of conditional payment claims

U.S. Department of the Treasury
Experienced lien services team working with you to take the necessary steps to avoid U.S. Treasury Department collections, providing claims resolution and searches to discover any other problematic claims

Section 111 Reporting

MSP Navigator®
comprehensive Section 111 reporting tool with integrated conditional payment and Medicare Set Aside guidance 

MMSEA Section 111 Compliance Audit
A review of your Section 111 reporting process — to help you avoid penalties, improve workflow, and reduce loss costs

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Medicare Set-Asides

Pre-MSA
An analysis of the potential amount of the Medicare Set-Aside for a claim — to help you determine if settlement of the case is feasible

Pre-MSA Plus
An analysis of the potential amount of the Medicare Set-Aside for a claim, together with an assessment of the prescription medications involved — to help you determine if settlement of the case is feasible and proactively address the cost drivers

Medicare Set-Aside
A medical and legal approach to help you comply with Medicare requirements, regardless of the type and size of your settlement

Medical Cost Projection
A forecast of reasonable and likely future medical costs for an individual claim to help you set reserves and proactively plan for settlement

Legal Zero
Services — based on legal advocacy — to help you reduce the cost of Medicare Set-Asides to $0 in appropriate cases

Non-Submit Allocation
A plan to ensure compliance, control costs, and cover future medical costs when a beneficiary receives a settlement that does not meet MSA review guidelines

MSA Clinical Review
An analysis of the pharmaceutical costs associated with a Medicare Set-Aside

WCMSA CMS Submissions
Settle workers’ compensation claims fairly, cost-effectively—and fast! Our legal and medical experts work together to review every single counter received by CMS and alert our clients to any opportunity for rebuttal.

Management

Protocol Design Service
Help with designing your own procedures for complying with Section 111 reporting, conditional payments, and Medicare Set-Aside requirements

Settlement Consultation Services
A consultative approach to drive settlements quickly and cost-effectively