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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.

Medicare 2022 Watch List: Get on Top of this Year’s Big Issues

Medicare 2020 Watchlist Report Cover Image

From Section 111 updates to implications of the PAID Act going live to new MSA trends, insurers are facing formidable MSP challenges on many fronts in 2022. Prepare for the year ahead by downloading our report, Medicare 2022 Watch list: Getting on Top of this Year’s Big Issues.

Download the report

Discover Verisk’s robust claim insights and compliance support

 

Discover Verisk’s robust claim insights and 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?

Section 111 Reporting Brochure

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.

Download the report

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.

Hit a Compliance Home Run with 6 Winning WCMSA Strategies

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With the ever-changing world of Medicare compliance, it’s never been more important to have a winning game plan ready. Verisk has a new guide to what works and how to set up your own successful WCMSA approach.

Download now

98% retention of contracted clients

Conditional Payment dispute and appeal services

Medicare Liens

Conditional Payment dispute and appeal services

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 future allocations

Future Allocation Services

Cost containment for 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.

Nearly $160 million saved in proactive cost mitigation

Holistic Compliance Solutions

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Holistic Compliance Solutions

Watch our expert panel as they unpack services that can help improve your Medicare compliance practices.

Discover the latest insights

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CMS discusses the MSPRP’s “go paperless” function at recent webinar

CMS held a webinar to discuss the Medicare Secondary Payer Recovery Portal’s (MSPRP’s) “Go Paperless” function.

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CMS to hold webinar to address MSPRP “go paperless” function

The Centers for Medicare and Medicaid Services (CMS) has announced that it will be holding a webinar on April 13, 2022 at 1:00 p.m. EST.

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CMS on the move: Section 111 civil money penalties Final Rule and Future Medicals proposals are pending review for release

The OIRA website indicates that CMS’s long-awaited S111 CMP “final rule” and their “Future Medicals” proposals are completed and are now pending OIRA review for release.

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CMS holds WCMSA webinar CMS discusses non-submit/EBMSAs, allocation pricing, denials, and other important WCMSA topics

On February 17, 2022 the Centers for Medicare and Medicaid Services (CMS) held a webinar session to address workers’ compensation Medicare set-aside (WCMSA) issues.

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Complementary 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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