Section 111 regulations can drain valuable adjuster resources and reporting errors can be costly. Our robust CMS reporting solution and review services enable insurers to easily fulfill their compliance obligations, while laying the groundwork for a strong compliance program that mitigates future medicals’ exposure and helps reduce overall spend.
When it comes to Section 111 reporting, the stakes are very high, with potential Section 111 civil money penalties of up to $1,000 per day (adjusted for inflation yearly), plus other possible liability including conditional payment “double damages” and Treasury actions.
Nearly 100% of Section 111 claims reported to CMS through MSP Navigator® contain ZERO errors. Based on data from nearly 5,000 RREs and 200 million claimants queried.
MSP Navigator® is a highly accurate Section 111 reporting solution supported by our team of legal and medical experts. The solution not only reports data but also provides CMS compliance analytics. Integration options are available for customers with ISO ClaimSearch® as well as API integrations with many of the leading claims systems.
We can provide your claims team with a comprehensive report on your Section 111 compliance. We’ll identify any problems in your current process and provide detailed recommendations to improve.
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Assistance with obtaining the necessary authorization forms to request claimant SSDI information and contacting the local Social Security Administration Office and obtain the claimant’s Medicare and Social Security Disability status.
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An off-cycle Section 111 query to quickly determine an individual’s Medicare status and verify whether they are a Medicare beneficiary.
In this session, the panel examines how improper reporting can create unnecessary conditional payment exposure.
Trigger a public records search to identify pertinent and required claimant information, including social security number and date of birth. Reduce your claimants outreach efforts and ensure compliance on every file with this new feature.
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.
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.
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.
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.
*based on 2021 data from nearly 5,000+ RREs and 200 million claimants’ queried.
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