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Medicare Future Allocations

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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. ISO Claims Partners has a range of services to help you comply and expertly manage expenses.

Verisk Acquires Franco Signor

 

Our new acquisition enables ISO Claims Partners to offer the most comprehensive suite of fully integrated Medicare compliance solutions and the nation’s top Medicare experts all under one roof.

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Get insight on key MSP compliance issues

Medicare Watchlist 2021

Get insight on key MSP compliance issues

Major changes are on are the horizon in Medicare compliance that can significantly affect your business efficiency, costs, and bottom line. Read our report, Medicare 2021 Watch List: Navigating the Big Changes Ahead, to learn about the latest updates and trends and how to prepare for them.

Determine accurate Workers’ Comp Medicare Set-Asides (WCMSAs)

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When it comes to determining a workers’ compensation claimant’s future medical costs, accuracy is key to successful CMS compliance. Insurers also need to protect their interests by ensuring that CMS demands align with injuries related to the claim. ISO Claims Partners offers a wide range of allocation services to help achieve both compliance goals.

Clients saved $4.5 million in Medicare Set-Aside rebuttals and re-reviews in 2020.

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Medicare Set-Aside (MSA)

ISO Claims Partners has the largest team of medical and legal experts dedicated to CMS compliance and accurate development of Medicare Set-Asides (MSAs). Our team partners with insurers to reduce costs and optimize claim settlement.

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Medical Cost Projection (MCP)

Our team of nurse practitioners analyzes medical records to develop future medical costs for claims. Insurers receive an assessment of medical exposure to determine if settlement is possible.

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3 real-world MSAs before and after

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~$800,000 saved

Working with the claims handler, we obtained a physician record indicating Duexis was replaced by meloxicam which reduced the allocation.

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~$500,000 saved

We submitted an amended review that was approved to reduce the MSA decision, most notably to remove the medications Lyrica and Trazadone.

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$400,000+

We successfully argued that Medicare erroneously included the injections as not medically necessary and that a functional restoration program was more appropriate. CMS agreed and reduced the MSA approval.

Innovative solutions across lines of business

Improve MSA settlement outcomes with a proactive approach

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Improve MSA settlement outcomes with a proactive approach

Workers’ comp insurers can receive a snapshot of potential MSA cost drivers, providing them with the opportunity to intervene before the full spend of the MSA.

Making amended review work for you

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Making amended review work for you

Our consultative approach allows workers’ comp insurers to make the most of CMS Amended Review opportunities. MSA Second Look client savings totaled $6.7 million from 2017 to 2018.

The fast, economical solution for all your future medical allocation needs

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The fast, economical solution for all your future medical allocation needs

With an ISO Claims Partners EBMSA, we help you determine the future medical costs of a Medicare beneficiary (or potential beneficiary) who receives a settlement that isn’t appropriate for CMS review.

Why over-allocate? Setting aside zero dollars is an option

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Why over-allocate? Setting aside zero dollars is an option

If a “zero MSA” is appropriate based on the medical and/or legal facts of the case, our experienced legal team prepares case-specific arguments and stand ready to defend them before CMS.

Your claim has settled, now what?

Caremdrx

Your claim has settled, now what?

CareMDRx provides access to some of the country’s largest healthcare and pharmaceutical networks. As an individual managing your future medical fund as a Medicare beneficiary or reasonably expected Medicare beneficiary; or because you pay out of pocket for your treatment, this program can save you money.

Our CMS approval rate for Legal Zero allocations is 95%

Settlement Services

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ISO Claims Partners’ team of medical and legal experts can remove obstacles to closing complex claims. We’ll help identify a book of claims to tackle, coordinate settlement conferences, and expedite preparation of MSAs or conditional payments. You’ll achieve large-scale claims resolution from a concentrated, time-efficient effort.

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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

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.

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.

Empowering insurers to comply fully with Medicare

Medicare Compliance Reporting

Empowering insurers to comply fully with Medicare

Navigating the complex and ever-changing Medicare compliance landscape can be challenging. That’s why the ISO Claims Partners team of legal and medical experts has developed a range of efficient and accurate Medicare compliance services supported by industry data and claims analysis.

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Other Ways to Connect

We are available Monday through Friday, 7 a.m. — 9 p.m. US Eastern Time:

  • Chat Now

    Note that password resets and user information are not available through Live Chat or Email. Instead, please call the main toll-free number below.

  • Main Toll-Free: 1-800-888-4476

  • Global Toll-Free: International Access code, then 800 48977489

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    We offer easy access via our online form but can accommodate e-mail, fax, mail, or arrange a pickup from your office. Contact your local ISO Claims Partners sales representative or e-mail us at referrals@iso.com.

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