Claims

Cms S111 Nghp Blog Image With People Standing And Smiling

11/20/2025 - 16 min read

CMS releases Section 111 NGHP User Guide (Version 8.2)

CMS released Section 111 NGHP User Guide 8.2, noting updates in policy, technical requirements, and appendices impacting NGHP reporting.

11/19/2025 - 3 min read

CMS Retains its $750 “Low Dollar” Threshold for 2026

CMS has released its 2026 low dollar reporting and recovery thresholds. CMS is retaining its current $750 low dollar reporting and recovery threshold.

11/18/2025 - 13 min read

Defendant Ordered to Pay Full Settlement Amount – Despite Payment to CMS

An opinion from the Court of NJ addressed a situation where a defendant’s TPA reimbursed Medicare’s conditional payment claim directly.

11/18/2025 - 7 min read

Medicare Payment Advisory Commission Report Submitted to Congress

This article will discuss Medicare’s recently released “2025 Annual Report of the Boards of Trustees of the Federal Hospital Insurance.”

11/13/2025 - 8 min read

The Longest Federal Government Shutdown in History Ends

The longest federal shutdown in history ends. Learn what’s next for funding, Medicare, and compliance activities.

11/12/2025 - 5 min read

Provider Analytic Outliers, Trends, and Patterns Five Areas to Look Out For

Explore five key billing behaviors: Ghost rides, rogue TINs, and more—that signal fraud risk in medical provider data.

11/10/2025 - 3 min read

Filling the Total-Loss Gap in Anti-Fraud and Theft Recovery Workflows

Exclusive data and automation capabilities open a digital window to online marketplaces to investigate insurance fraud or find stolen cars.

10/31/2025 - 2 min read

A Better Match Report Is Here: The New ClaimSearch Arrives November 5

Discover the redesigned ClaimSearch Match Report, built for faster insights, smarter claims decisions, and future-ready performance.

10/30/2025 - 1 min read

Verisk’s New Bodily Injury Solution Comes to the Guidewire Marketplace

Discover how Verisk’s Liability Navigator accelerator helps insurers improve settlements, cut integration time by 90%, and make data-driven bodily injury decisions.

10/29/2025 - 4 min read

Digital Empowerment for Tomorrow’s Workers’ Compensation Claims Teams

Outdated and inefficient claims processes are creating operational drag and putting many workers’ compensation insurers on a collision course with millennial and Generation Z workforce trends.

10/24/2025 - 2 min read

Reconstruction Costs Continue Easing Trend

The latest 360Value^® Quarterly Reconstruction Cost Analysis report gives an overview of current reconstruction cost trends at the national and state levels for the United States from October 2024 to October 2025.