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Medicare Teaser
December 22, 2022

Is the other “M” on your radar? 5 things to know about Medicaid and how we can help!

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

Cms Future Medicals Teaser
November 9, 2022

Back to the drawing board: CMS’s future medicals proposals are withdrawn – where does this leave LMSAs?

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in our October update, the Centers for Medicare and Medicaid Services’ (CMS’s) future medicals proposals have been withdrawn.

Circuit Court Teaser
October 31, 2022

U.S. Circuit Court of Appeals for the Second Circuit rules that Medicare Advantage Plans can sue insurers for “double damages” – ruling affirms the district court’s award of double damages against insurer

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

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June 30, 2022

Claims commitment: Empowering insurers on the innovation journey

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

Simplify Streamline Innovative Solutions
March 23, 2022

Simplify, streamline, and automate the total loss process

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

Lienholder Clauses
November 29, 2021

Solving the puzzle of lienholder clauses

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

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March 1, 2021

CMS to host BCRC and CRC NGHP town hall on April 1st

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, at 1:00…

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December 16, 2020

LMSA update: CMS’s “future medicals” proposals now scheduled for release in March 2021 | New LMSA case decision highlights continuing claims challenges

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

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December 7, 2020

New case highlights how LMSA issues and questions continue to complicate liability claim settlements

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…

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November 30, 2020

CMS retains $750 low dollar threshold for 2021

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

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November 10, 2020

CMS NGHP Beneficiary Recovery Process webinar December 9th

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.

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October 23, 2020

Maximizing recovers boost customer satisfaction better subrogation

An effective subrogation operation is built on data and analysis

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October 12, 2020

Automation requires emotional intelligence to deal with large loss claims handling

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.

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October 6, 2020

CMS releases new NGHP Section 111 User Guide (Version 6.0) and updated accepted/excluded ICD code listings

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.

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September 10, 2020

The future of claims: Delivering at the moment of truth

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

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