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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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 7.2 million Medicare Set-Aside rebuttals and re-reviews in 2019.

Msa

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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MSA cost reductions from ISO Claims Partners

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$1.4 million saved

We demanded CMS re-review of a WCMSA by successfully arguing that CMS failed to appropriately acknowledge a court decision that excluded a major condition as nonindustrial.

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$580,000 saved

We recommended an Amended Review (through CMS’s new Amended Review process) that led to a dosage adjustment.

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$345,000 saved

We collaborated with the physician and adjuster to determine the spinal cord stimulator and associated medications were no longer recommended, resulting in future medicals reduction.

Innovative solutions across lines of business

Improve MSA settlement outcomes with a proactive approach

Pre Msa

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

Msa Second Look

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

Ebmsa

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

Legal Zero

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

If a claim is fully denied and no future dollars need to be set aside, our legal team will prepare case-specific arguments and stand ready to defend them to CMS.

CMS approval rate for Legal Zero allocations is 93 percent.

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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  • Main Toll-Free: 1-800-888-4476

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