Throughout the year, experts from Verisk will host web seminars focusing on topical issues facing the industry. Additionally, we'll feature new and/or improved product offerings in our product spotlight series.

Our web seminars are complimentary and open to all ISO participating insurers, agents, brokers, and risk managers.

Section 111 Cause and Effect: Understanding the Downstream Impact between Reporting and Medicare Conditional Payments

There is a direct connection between Section 111 reporting and Medicare’s conditional payment recovery process. Using Section 111 data to holistically drive conditional payment compliance is the key to reduce your exposure, including Treasury recovery actions and offsets.

In this session, the panel examines how improper reporting can create unnecessary conditional payment exposure. It will also cover how insurers can use Section 111 reporting to build proactive practices to identify, dispute, and resolve conditional payment claims

Finally, we will explore how the PAID Act can help insurers get ahead of the curve to tackle Medicare Advantage and Medicare Part D recovery claims and avoid “double damages.”

Topics to be addressed include:

  • Section 111 and conditional payments: seeing the big picture
  • Query Process: setting the path for proactive compliance
  • TPOC/ORM: avoiding downstream exposure for conditional payments
  • ICD codes: finding the balance and getting it right
  • PAID Act: using the new law to your advantage
  • Making it work better: improving your practices to reduce exposure and settle claims

Presentation Date

Monday, June 14, 2021
2:00 p.m. ET

Speakers

Mark Popolizio
VP, MSP Compliance
ISO Claims Partners

Sid Wong
AVP of Policy
ISO Claims Partners

Jeremy Farquhar
Senior Product Consultant
ISO Claims Partners

Holistic Compliance Solutions to Help Avoid Section 111 Penalties, Reduce Conditional Payment Exposure, and Settle Claims  

With Section 111 civil money penalties (CMPs) at the door, increasing CMS recovery actions, and the upcoming PAID Act changes, insurers are at a critical crossroad regarding Medicare secondary payer compliance. Now more than ever insurers need programmatic solutions to stay compliant, simplify workflows, and reduce costs.

Join our expert panel as they unpack services that can help improve your Medicare compliance practices including Section 111 Audit; MSP Navigator®; and CP Link®

Presentation Date

Thursday, June 17, 2021
2:00 p.m. ET

Speakers

Mark Popolizio
VP, MSP Compliance
ISO Claims Partners

Brian Cowan
VP Administrative Solutions
ISO Claims Partners

Dan Lindner
National Account Executive
ISO Claims Partners

Getting the Right Results from Your Fraud Analytics

More carriers are turning to advanced analytics to help detect fraud in their claims. While these powerful analytic models offer great promise in combating claims fraud, there are challenges in getting the right insights to improve investigations.

This session will explore the latest advancements in AI analytics as well as how you can get actionable insights to inform investigative decisions.

Topics will include:

  • Advancements in AI analytics
  • Challenges in providing contextual guidance for investigators from models
  • How to operationalize results from sophisticated models
  • How to create better analytics and actionable insights

Who Should Attend

SIU leaders, SIU analysts, investigators, claims executives and managers, data scientists 

Presentation Date

Monday, June 28, 2021
2:00 p.m. ET

Speaker

Rafael Conde
Director Product Innovation
ISO Claims Solutions

Jim Hulett
VP, Anti-fraud Solutions
ISO ClaimSearch

Reducing WCMSAs and Alternative Compliance Considerations:
Helping Your Client Lower Allocations and Get Claims Settled

High workers’ comp Medicare Set-Aside (WCMSA) allocations continue to frustrate workers’ compensation insurers and prevent claim settlement. But counsel and their clients often have more options than they realize to lower WCMSA allocations and fight back against CMS.

This session examines proactive measures you can take to control WCMSA costs and get cases settled.

Topics include:

  • Lowering RX costs
  • Handling surgical recommendations
  • Taking advantage of CMS’s allocation
  • Challenging CMS’s WCMSA determinations
  • Getting zero MSAs approved
  • WCMSA non-submission options

Who Should Attend

Product innovators; Commercial Auto Underwriters; Project Managers

Presentation Date

Monday, July 19, 2021
2:00 p.m. ET

Speakers

Mark Popolizio
VP, MSP Compliance and Policy
ISO Claims Partners

Sid Wong
AVP, Policy
ISO Claims Partners

Angela Wolfe
VP, MSP Solutions
ISO Claims Partners

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