Shawn Deane
CRC transition update: Temporary halt on recovery activities
On February 2, 2018, CMS issued its latest update regarding the Commercial Repayment Center transition from CGI Federal to Performant Financial Corporation.
Government shutdown & Medicare Secondary Payer impact
Medicare Secondary Payer operations will not be affected as they are essential and considered part of the Medicare Integrity Program. However, were are receiving word…
CMS holds town hall call on CRC transition - CMS provides important updates on ORM recovery transition
On January 18, 2018, CMS held its Commercial Repayment Center Non-Group Health Plan (NGHP) Town Hall presentation to address the upcoming transition of CRC operations…
CMS schedules NGHP CRC transition webinar for January 18, 2018
The Centers for Medicare and Medicaid Services (CMS) will be holding a webinar on Thursday, January 18, 2018 at 1:00 PM ET to provide information and details related to…
CMS extends CRC transition to February 8, 2018
The Centers for Medicare and Medicaid Services (CMS) is extending the Commercial Repayment Center (CRC) contract transition from CGI Federal to Performant Financial…
Performant awarded CMS Commercial Repayment Center contract
The Centers for Medicare and Medicaid Services (CMS) awarded Performant Financial Corporation (Performant) the Commercial Repayment Center (CRC) contract.
Medicare Section 111 process change eases one compliance burden
RREs will no longer automatically be moved into “discontinued” status if they fail to provide Medicare the requested annual recertification information.
Fact check time for LMSA/NFMSA developments
The real question is: What, when, and how is CMS going to step into the liability and no-fault arena and how will it affect claims management?
Risky business: Five essential tips for Section 111 reporting
Your Section 111 reporting program may seem clear-cut, but it can mean risky business if your team isn’t prepared to avoid common compliance mistakes.
Liability MSAs: What we know and what to expect
The dust is still swirling around the Liability Medicare Set-Aside (LMSA) issue, but a few areas clearly show Medicare’s plan and intended next steps.
CMS updates Medicare Secondary Payer Recovery Portal
On October 11, 2016, the Centers for Medicare and Medicaid Services (CMS) released a new, updated version of the Medicare Secondary Payer Recovery Portal (MSPRP) User…
Conditional payment disputes mired in Medicare appeals backlog
Insurers seeking appeals of adverse conditional payment decisions are finding that their cases are dragging.
The compliance gap: How you see your compliance vs. how Medicare sees it
There are two main categories of Medicare compliance: (1) reporting and (2) recovery. Although the law and regulations clearly state what must be done in each category…
Preparing for a fundamental compliance shift in liability claims
Liability claims are particularly at risk, as these emerging compliance issues impose new burdens on the management and settlement of claims.
Removing impediments to settlements: Conditional payments in liability claims
While liability conditional payments can present some unique challenges, there are effective methods to remove the stumbling blocks to claims resolution.