Conditional Payment Services

Pay what you owe and nothing more

ISO Claims Partners Conditional Payment Services consist of investigation, consultation, and compliance services that can help you challenge and reduce Medicare's "liens" — or demands for reimbursement of conditional payments. The services can help make sure you pay what you owe and nothing more.

Background
If the claimant in a workers compensation or liability case is a Medicare beneficiary, Medicare may make conditional payments to healthcare providers. The program will then have "liens" on any settlements the claimant may receive from an insurer or other payer. Section 111 mandatory insurer reporting gives the Medicare program an unprecedented amount of information on such claims. Using that information, the Medicare Secondary Payer Recovery Contractor (MSPRC) can simply demand reimbursement. According to some estimates, Medicare seeks recovery of more than $3 million per thousand claims. If you don't pay what you owe, Medicare can refer your case to the U.S. Department of the Treasury for collection. And in some situations, you may be liable for double damages. You need to develop a comprehensive approach to mitigate that liability and reduce costs. ISO Claims Partners has data indicating that such an approach can save you — on average — more than $2.5 million in aggregate Medicare Secondary Payer (MSP) exposure per thousand claims.

Challenging Medicare's demands for reimbursement
Many vendors can't or won't aggressively challenge MSPRC demands for reimbursement of conditional payments. But ISO Claims Partners Conditional Payment Services give you a team with the experience to identify issues and advance legal arguments that can reduce Medicare's demands. The result is an average savings of 83 percent per claim.

For more information about ISO Claims Partners Medicare compliance services

Representatives are available Monday through Friday, 9 a.m. through 8:30 p.m. Eastern time.