Settlement

It is no secret that Medicare secondary payer compliance issues often dominate the claims landscape and discussion.

As reported in our October update, the Centers for Medicare and Medicaid Services’ (CMS’s) future medicals proposals have been withdrawn.

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages”

The insurance industry has experienced tremendous change in the past few years.

When a vehicle is deemed a total loss, it can take days or weeks for the auto insurers to notify and pay the lienholder.

For insurers, validating correct lienholder information on loss payable and mortgagee clauses can be a long and cumbersome process.

CMS has announced it will be holding a Benefits Coordination & Recovery Center and Commercial Repayment Center Non-Group Health Plan town hall on April 1, 2021.

LMSA update: OIRA has issued an updated noticing indicating CMS’s “future medical” proposals are delayed again and projected for release in March 2021.

In Abate V. Wal-Mart Stores East, L.P. the court found CMS’s 9/30/11 memo didn’t mandate the plaintiff get a letter from her doctor certifying treatment was completed or…

CMS has announced it is retaining its current $750 low dollar threshold for 2021.

CMS has released a notice announcing that it will be holding a Non-Group Health Plan (NGHP) Beneficiary Recovery Process webinar on December 9, 2020, at 1:00 p.m. ET.

An effective subrogation operation is built on data and analysis

Large loss claims can be streamlined by AI and automation, but needs the emotional intelligence brought to claims resolution by the handler and the insurer.

On 10/5/20, CMS released an updated Section 111 NGHP User Guide, V. 6.0. They also released updated versions of accepted and excluded ICD-9 and ICD-10 codes for 2021.

The future of claims is about elevating the customer experience, and insurers that aggressively pursue digital enablement today will be primed to excel tomorrow.