Workers' Compensation Services

The stakes are high when dealing with Medicare conditional payments. With the right advocate, you can save money, mitigate exposure, and ensure resolution of claims. As an industry leader, ISO Claims Partners is uniquely positioned to ensure proper compliance with CMS’s Medicare Secondary Payer (MSP) contractors for all lines of business while also delivering maximum cost and time savings.
With Section 111 reporting, you’re already sending Medicare all the data it needs to seek recovery on conditional payments. Now you can put that same data to work for you. Addressing Medicare exposure programmatically and taking a more active role in defending against inappropriate recovery claims are what CP Link is all about.
ISO Claims Partners Legal Zero is a set of services that can help you reduce the cost of individual Medicare Set-Asides (MSAs) to $0 in appropriate cases. To get the most favorable agreement with Medicare on an MSA, you need to consider both medical and legal issues involved in the underlying claim. Why should you allocate money for future medical treatment when you aren’t the primary payer? Why increase the cost of a settlement when you’re dealing with a denied or disputed claim? Why abandon state law defenses just because the case involves Medicare?
The Medicare Secondary Payer (MSP) statute charged the Centers for Medicare and Medicaid Services (CMS) with protecting Medicare’s “future interests,” and CMS identified Medicare Set-Asides (MSAs) as the preferred way to allocate payment for future treatment. In 2006, ISO Claims Partners developed an exceptional approach that revolutionized the MSA industry. Combining medical and legal advocacy on every claim, our MSA Allocation Services save our clients significant time and money.
An MMSEA Section 111 Compliance Audit from ISO Claims Partners is a detailed review of your Section 111 reporting process. Such an audit can help you avoid penalties, improve your workflow, and reduce loss costs.
An MSA Clinical Review from ISO Claims Partners is an analysis of the pharmaceutical costs associated with a Medicare Set-Aside (MSA) case. The review defines — in collaboration with the treating physicians — the appropriate current and long-term pharmaceutical regimen, with a special focus on narcotics.
Eliminate the guesswork and compliance gaps from your Section 111 reporting with MSP Navigator. As the most advanced system in the industry, MSP Navigator not only reports data but also provides analytics that offer insight and guidance to help you manage claims and ensure proactive compliance.
Turn to an ISO Claims Partners Non-Submit Allocation for cases that don’t require Centers for Medicare and Medicaid Services (CMS) review. Non-Submit Allocation will help resolve the claim contingent on primary payer protocol, claimant concerns, jurisdictional considerations, and settlement type.
PAAS Classification Guides Accurate classification of risks is an indispensable part of the premium audit process. Risk classification is also essential to underwriting and rating. To help you classify general liability and workers' compensation risks, ISO's Premium Audit Advisory Service (PAAS ® ) has developed more than 40,000 classification guides....
Pre-MSA Plus from ISO Claims Partners provides an analysis of the potential amount of the Medicare Set-Aside (MSA) for a claim — together with as assessment of the prescription medications involved. The service helps you determine if a settlement of the case is feasible under the current treatment plan. Pre-MSA Plus also uncovers treatment changes that could mitigate costs and lead to an improved outcome for the claim.
Pre-MSA from ISO Claims Partners provides an analysis of the potential amount of the Medicare Set-Aside (MSA) for a claim. The service helps you determine if a settlement of the case is feasible — and identify issues you can address before settlement to reduce the MSA amount. So, Pre-MSA is a proactive approach to compliance and resolution.
Medicare Secondary Payer (MSP) compliance continues to present challenges for claims payers. You need a game plan from day one. Recognizing how to navigate the major MSP issues affecting claims should be an integral part of any effective claims-handling practice. The ISO Claims Partners Protocol Design Service can help you meet the challenges.