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"New federal regulations and penalties take effect in July 2009," saidPaula Woolworth, Vice President of MedInsights, Inc. "We can help companiesand third-party administrators comply with the law today."
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Medicare Secondary Payor Compliance Unit
Insurers and employers have significant new legal responsibilities whenidentifying and settling workers' compensation and other liability or benefitcases. These responsibilities require reporting to Medicare and that futuremedical expenses be accurately forecast and approved by Medicare regulators,and that such settlements be allocated or "set aside" for future payment ofsuch expenses. Obtaining that approval and maintaining overall complianceinvolves a complicated confluence of state and federal laws, and non-compliance can trigger significant fines, including new penalties that takeeffect July 1, 2009.
For any claim requiring future cost allocation, MedInsights conducts athorough review of the case to determine the beneficiary classification,forecast anticipated costs, and ensure compliance with Medicare regulations.
"We have trained adjusters, nurses and certified life care planners whoassure that clients' interests are protected through this service," saidWoolworth.
To consider Medicare's interests, MedInsights' Compliance & ResolutionUnit will work with a business partner to obtain a Medicare Set Aside (MSA)report where required. The Compliance & Resolution Unit also will completefuture cost projection reports on cases not warranting a full MSA allocationreport. Additionally, the Unit will oversee compliance and alternative fundingoptions, such as structured settlements, for MSA accounts.
Medical Benefit Account
MedInsights will offer the use of a new Medical Benefit Account, post-settlement, to assist in stretching claim settlement dollars via bill reviewmanagement system and by using medical network partners to obtain discountedproducts and services.
"This account will allow claimants to reap the rewards of bill reductionsand negotiated medical service discounts," said Woolworth. "These savingscould stretch a settlement by up to 40 percent by allowing the claimant thebenefits of the above reductions."
MedInsights is featuring this new product at the Risk & InsuranceManagement Society's Annual Conference in San Diego this week. Additionalinformation is available at GAB Robins' trade show booth (#2401) or via e-mailat [email protected].
MedInsights, Inc., a subsidiary of GAB Robins North America, Inc., is aleading provider of managed care and rehabilitation services. For moreinformation, please visit www.medinsights.com.
SOURCE MedInsights, Inc.
