We provide a wide range of claims compliance solutions—from extensive MSP services to efficient EDI reporting—as well as proven predictive analytics that improve workers’ compensation and liability claims management.
For a superior compliance program and data-driven claims insights, talk to Verisk today.
With our support and insight, customers are achieving greater efficiencies, maintaining full compliance, and making better decisions. Check out the results for yourself!
Insurers have been meeting the challenges of Medicare Secondary Payer (MSP) compliance for a while, but increasingly the demands of the other M—Medicaid—also need attention. Read this detailed article to learn the full scope of advancements in Medicaid recovery, and learn what this means for your organization.
Are your old claims lying around the office or floating in the cloud, waiting to be closed? The longer these files stay open, the more involved they become, potentially leading to higher costs and putting a strain on resources. What can you do to resolve them?
Find out how to get the most from automation initiatives to reduce costs, manage medical treatment, improve outcomes, and improve return-to-work timelines.
A predictive analytics model is only as good as the data it analyzes. And if that data is inaccurate, it can lead to inconsistent settlements, claim leakage, and higher costs. Learn about the most common barriers to effective data analytics and how to overcome them.
Millions of Dollars Saved
Clients saved nearly $150 million in Medicare conditional payments in 2020.
The complexities of claims compliance are daunting—and expensive. That’s why we offer a full range of holistic Medicare Secondary Payer (MSP) reporting and cost-containment solutions that save time and reduce spend. We also offer streamlined FROI/SROI and EDI reporting to empower insurers to meet the requirements of every state.
The insurance industry has experienced tremendous change in the past few years.Read the article
In a major MSP compliance development, the RAMP Act was introduced into the United States House of Representatives on June 14th.Read the article
The Court rejected the plaintiff’s argument that Medicaid’s recovery was limited to only that portion of the settlement representing past medical care.Read the article
When the CMS released version 3.5 of the WCMSA reference guide on January 11, 2022, it redefined the potential risk and settlement considerations.Read the article
Exceptionally Accurate MSP Reporting
For Section 111 claims reported to CMS through MSP Navigator®,
99.9% contained ZERO errors.*
Complying with Medicare’s demands for future medical allocations requires deep knowledge of both medical and legal aspects of injury claims. We have a range of services to help you comply and expertly manage expenses.
Section 111 reporting requirements don’t have to weigh down your claims-handling staff. Our robust CMS reporting solution and review services enable insurers to easily fulfill their obligations to identify and report Medicare recipients in claims.
Our team of legal and medical experts has developed a broad range of conditional payment services regarding the U.S. Department of Treasury, Medicare Advantage, and Medicaid to facilitate seamless, worry-free compliance while reducing costs.
Evaluating general damages for injury claims, pinpointing liability, determining fair settlements, and finding subrogation are all vital to effectively managing claims and preserving insurers’ bottom lines. But carriers have been challenged to accomplish these goals while resolving claims as quickly as possible.
Accurately determining workers’ compensation claim severity early is key to controlling claim costs. wcNavigator® uses predictive analytics to help adjusters and claims managers accurately identify claim severity as early as day one.
Workers’ compensation data compliance reporting is challenging; insurers must carefully format and submit detailed claim and policy data to state jurisdictions and data collection organizations. Verisk has solutions for all workers’ compensation compliance reporting needs that will help save time and improve reporting accuracy.
Workers’ compensation data compliance reporting is challenging. Insurers must carefully format and submit detailed claim and policy data to state jurisdictions and data collection organizations. Verisk has solutions for all workers’ compensation compliance reporting needs that will save time and improve reporting accuracy.
Discover High-Complexity Workers’ Comp Claims
Predictive analytics found high-severity claims 40 days faster
Workers’ compensation insurers are challenged with managing complex claims, rising claim severity, and stringent reporting obligations. And with many experienced claims handlers nearing retirement, the challenges become even more daunting.
Navigating the complex and ever-changing Medicare compliance landscape can be challenging. That’s why our team of legal and medical experts has developed a range of efficient and accurate Medicare compliance services supported by industry data and claims analysis.
ClaimSearch® is more than the world’s largest database of property/casualty claims—it’s also a robust claims intelligence platform. Its claims-matching technology is an essential first step in fraud detection, and the results can help facilitate fast-tracking. The platform also provides seamless access to integrated claims fraud-detection and investigative analysis tools.
*Based on 2019 data of 5,000+ RREs and over 200 million claimants queried.
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