Settlement
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.
Back to the drawing board: CMS’s future medicals proposals are withdrawn – where does this leave LMSAs?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in our October update, the Centers for Medicare and Medicaid Services’ (CMS’s) future medicals proposals have been withdrawn.
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”
Claims commitment: Empowering insurers on the innovation journey
The insurance industry has experienced tremendous change in the past few years.
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.
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.
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…
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.
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…
CMS retains $750 low dollar threshold for 2021
CMS has announced it is retaining its current $750 low dollar threshold for 2021.
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.
Maximizing recovers boost customer satisfaction better subrogation
An effective subrogation operation is built on data and analysis
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.
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.
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.