Recently, a client asked, “If I submit a Medicare Set Aside (MSA) to the Centers for Medicare and Medicaid Services (CMS) for review and approval, will it be approved? True story: A few years ago, when the Workers Compensation Review Center (WCRC) was in Baltimore,… Read More »INSIDER SECRETS: CMS Review and Approval of MSAs
Using the POWER of DATA for Accuracy in Compliance Are you frustrated with Medicare Set Aside results? Do MSAs often preclude settlement? We randomly polled carriers, third party administrators, self- insured employers, and state / mutual funds in 2016 and out of 36 respondents,… Read More »Analytic-Powered Medicare Set Asides:
Centers for Medicare and Medicaid (CMS) Townhall at WCI: A Summary Brief In case you missed Workers Compensation Institute’s 76th Annual Education Conference in Orlando, August 21-24, there was an interesting panel discussion with leaders from the Division of MSP Program Operations at CMS including… Read More »The Right Solution at the Right Time
As a data-driven company, we measure and watch the Centers for Medicare and Medicaid Services (CMS) Workers’ Compensation Review Center (WCRC) where workers compensation MSA (Medicare Set Aside) determinations are made. We compare each CMS determination against Care Bridge International’s proposed MSA for accuracy. A… Read More »BEWARE! Errors in the CMS MSA Review Process
YOU CAN BE fast and accurate! Calculating medical reserves is an important part of the workers compensation claims process, but it has historically been inaccurate and time-consuming. According to the American Society of Actuaries, in the past 4 decades, 100 insurance companies became insolvent mostly… Read More »Analytic-Powered Medical Reserve
We listened. We heard you. We’ve got the solution. WE ARE PROUD TO ANNOUNCE that we’ve partnered with INSURCARD MSA Debit to bring you a TOTAL payment solution to comply with Medicare Secondary Payer regulations. InsurCard is more than just a debit card; it’s a… Read More »Care Bridge International and InsurCard MSA
At times, when settling a disputed or denied claim, parties to the settlement opt to obtain a zero-dollar Medicare Set Aside (MSA) Allocation. A zero-dollar MSA simply means that a thorough narrative report, based on the medical/ legal facts of the claim, is presented to… Read More »When a Zero-Dollar Medicare Set Aside Isn’t Enough
On January 10, 2022 CMS Released an updated WCMSA Reference guide adding a new section, Section 4.3, entitled “The Use of Non-CMS-Approved Products to Address Future Medical Care.” Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5, January 10, 2022). Section 4.3 The Use of Non-CMS-Approved… Read More »CMS Announces Additional Clarification Regarding Non-Submit MSAs
A question for the reader – what comes to mind when you think about the claims experience? THE EMOTIONAL JOURNEY I have talked a little bit in the past about claims being perhaps the most emotional phase of the insurance lifecycle. In an industry that… Read More »Creating a Compassionate Claims Journey
Last month we talked about CMS’ new Section 4.3 of the WCMSA Reference Guide, entitled “The Use of Non-CMS-Approved Products to Address Future Medical Care.” Workers’ Compensation Medicare Set-Aside (WCMSA) Reference Guide (Version 3.5, January 10, 2022). Since the release of our blog, The National… Read More »The Conundrum of Medicare Set Asides: A Case Study