Claims
LMSA update: CMS’s “future medicals” proposals now scheduled for release in October 2021
CMS’s long-anticipated release of its “future medicals” notice of proposed rule making (NPRM) is now scheduled for October 2021.
CMS releases its PAID Act implementation plans – what’s next and how we can help
The following provides a general overview of the PAID Act, CMS’s implementation plans, and related considerations as follows.
New NGHP Section 111 User Guide (6.4) – PAID Act, ORM termination, and other updates
The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 NGHP User Guide (Version 6.4, June 11, 2021) regarding non-group health plans.
Litigation technology poised to enhance insurers’ case results
Many claims teams lack visibility into where the claim is at once it hits the litigation phase.
CMS to hold PAID Act webinar on June 23rd
The Centers for Medicare and Medicaid Services (CMS) has announced that it will be holding a webinar on June 23, 2021 at 1:00 p.m. (ET) regarding the Provide Accurate…
Insurers protected from fraud, waste, and abuse in P-Stim procedures
Medical provider fraud, waste, and abuse— which have largely eluded most insurers—is an insidious, often unseen, problem that can damage insurers’ margins.
From the high street to the smartphone: How the insurance industry can keep pace with digital transformation and shifting customer demands
Insurance service delivery has undergone extensive change, with customer convenience ushering in more and new technologies.
Tips to improve match report results in ISO ClaimSearch
Every day, claims professionals are challenged with evaluating and processing claims quickly and accurately.
COVID-19 and Workers’ Compensation Revisited: Navigating the pandemic to understand what’s next
Last year we discussed ways the pandemic could impact workers’ compensation claims. Now, nearly a year later, we reflect on some of the answers to those questions.
Post-Settlement Administration: What’s next after getting an MSA?
When a claim settles, many claimants find themselves with a large sum of money that they are required to manage on their own.
CMS releases updated Section 111 Model Language document
The Centers for Medicare and Medicaid Services has released an updated Section 111 Model Language document dated March 10, 2021 (PDF version).
CMS’s Section 111 penalty proposals – current status and FAQs
There remains much anticipation regarding the current state of the Centers for Medicare and Medicaid Services’ (CMS’s) Section 111 civil money penalties proposals.
CMS releases new NGHP Section 111 User Guide (Version 6.3)
The Centers for Medicare and Medicaid Services (CMS) has released an updated Section 111 NGHP User Guide (Version 6.3, April 5, 2021).
CMS holds BCRC and CRC NGHP Town Hall session
The Centers for Medicare and Medicare Services held what it billed as a Benefits Coordination & Recovery and Commercial Repayment Center non-group health plan Town Hall.
The COVID-19 journey for homeowners insurers: Building on lessons learned and new-normal strategies
Economic turmoil, lifestyle changes, and transitions to remote work amid the COVID-19 pandemic created a “new normal” for personal property insurance.