Medicare Compliance and Reporting

Empowering insurers to comply fully with Medicare

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.

Discover Verisk’s Robust Claim Insights & Compliance Support

 

For a superior compliance program and data-driven claims insights, talk to Verisk today.

What is the relationship between Section 111 reporting and conditional payment recovery efforts?

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Section 111 reporting and Medicare’s conditional payment recovery activities are directly related. This makes it important for insurers to know what the downstream effects of providing CMS with data and information to mitigate risk while maintaining compliance. Download our report, Section 111 Reporting: Cause and Effect, to learn about how mandatory reporting directly impacts recovery efforts.

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Efficient and accurate Section 111 Reporting

Section 111 Reporting

Efficient and accurate Section 111 Reporting

MSP Navigator® is the robust Section 111 reporting solution with integrated conditional payment and Medicare Set-Aside (MSA) guidance. For carriers wishing to fully assess their compliance program, we offer a detailed auditing service.

Improve claim outcomes through data, analytics, and advocacy

Improve Claims Outcomes

With our support and insight, customers are achieving greater efficiencies, maintaining full compliance, and making better decisions. See the results for yourself!

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98% retention of contracted clients

Medicare liens

Medicare Liens

Medicare liens

Insurers can fulfill their obligations to Medicare and Medicaid while keeping an eye on costs with our range of lien services. In addition, adjusters can streamline reporting and develop an automated approach to conditional payment compliance with CP Link®.

Cost containment for Medicare future allocations

Future Allocation Services

Cost containment for Medicare future allocations

Our range of Medicare future allocations services enable insurers to determine correct Medicare Set-Aside allocations and avoid overpayment. Our expert team provides insurers proactive recommendations to mitigate costs and reach faster settlements.

$135 million in savings by eliminating cost drivers in MSAs in 2020.

Discover the latest medicare compliance and reporting insights

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Federal rules committee recommends no immediate action for third-party funding disclosure rulemaking at recent meeting

Federal rules committee recommends no immediate action for TPF disclosure rulemaking at recent meeting

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CMS releases new NGHP Section 111 policy alert regarding the funding beyond the TPOC start date field

CMS “reminds” RREs to provide the actual or estimated date of funding in situations where funding of a TPOC will be delayed beyond the TPOC start date.

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CMS releases new NGHP Section 111 policy alert regarding the reporting of incorrect no-fault policy limits

The Centers for Medicare and Medicaid Services (CMS) has released a new NGHP Section 111 Policy Alert addressing the reporting of incorrect no-fault policy limits.

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Court finds that a LMSA for future medicals is not necessary as part of the parties’ liability settlement

CMS’s future medicals proposals now scheduled for release this month.

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Learn more about ISO Claims Partners solutions

Achieve full compliance for future medical allocations while managing expenses

Medicare Future Allocations

Achieve full compliance for future medical allocations while managing expenses

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.

Accurate Medicare reporting lets insurers comply with ease

Section 111 Reporting

Accurate Medicare reporting lets insurers comply with ease

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.

Mitigate compliance costs of Medicare and Medicaid liens

Lien Services

Mitigate compliance costs of Medicare and Medicaid liens

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.

Complex claims and compliance costs insurers

Workers Comp

Complex claims and compliance costs insurers

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.

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