Mitigate compliance costs of Medicare and Medicaid liens
The ISO Claims Partners 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.
Manage exposure for Medicare and Medicaid liens
With rising adjuster workloads and the ever-changing regulatory landscape, claims compliance is often best outsourced to a trustworthy partner. Insurers face a $1,000-a-day fine if compliance requirements aren’t met.
Conditional Payment Services
Our experts can work to reduce Medicare’s demands for reimbursement of conditional payment claims. From investigating to consulting, we take a “whole claim” approach to challenging unwarranted Medicare demands.
In 2018, our dispute efforts resulted in more than $40 million in savings.
Automate the Section 111 conditional payment process for complete MSP compliance
CP Link® is integrated into your Section 111 data reporting system, and it automatically identifies Medicare beneficiaries and initiates the Medicare conditional payment compliance process. Since every claim is checked, compliance gaps are reduced to assure full CMS compliance.
Identify conditional payment exposure early in the process
When insurance carriers and self-insureds identify claims that qualify for conditional payment investigations before Medicare does, they can control the conditional payment process better. CP Link streamlines investigating risk and helps eliminate exposure.
CP Link improves results of CMS compliance
- 91% reduction in conditional payment disputes
- 97.6% success rate of conditional payment disputes when engaged
- 65% of conditional payments reduced to ZERO when dispute is engaged
- Provides full insight/visibility (risk, efficacy, success)
- Saves time and conserves adjuster resources
- Maximizes cost mitigation
- Shifts complex and complicated processes to expert MSP personnel
ISO Claims Partners conditional payment services saved clients more than $43M and provided 600% ROI in 2018.
Winning conditional payment disputes with CMS
Since CP Link identifies all potential Medicare recovery exposure, there’s a tremendous opportunity to mitigate or eliminate these expenditures. Through CP Link, ISO Claims Partners challenges all charges that have a basis to be disputed or appealed, and we achieve reductions in conditional payments more than 90% of the time.
In 65 percent of disputes, conditional payments are reduced to zero.
U.S. Department of Treasury Services
Insurers can better identify and respond to U.S. Treasury collection efforts when partnered with the legal and medical experts at ISO Claims Partners. We’ll manage demands and fight to mitigate your exposure. Clients saved nearly $975,000 on disputes with the U.S. Department of the Treasury in 2018.
Medicare Advantage Plan (MAP) Services
Insurers can better navigate the complex world of Medicare Advantage Plans with help from ISO Claims Partners. Our experts continually monitor legal precedent in Medicare Advantage Plan cases to provide the most strategic path for your business.
In 2018, insurer clients saved over $270,000 in Medicare Advantage Plan disputes.
Medicaid Compliance Services
Protect your bottom line while staying compliant with Medicaid recovery in relevant states.
For additional lien services:
ISO Claims Partners
Helps insurers take control of claims, compliance, and costs
Medicare Future Allocations
Medicare Set-Asides and cost mitigation
Section 111 Reporting
Accurate Medicare reporting lets insurers comply with ease
Medicare Compliance and Reporting
A range of efficient and accurate Medicare compliance services