The most effective Medicare Secondary Payer compliance programs help claims settle quickly, easily, and with optimal cost containment. Rising has the medical management expertise and technology to deliver positive results and reduce Medicare compliance exposure.
Accurate & Defensible Medicare Compliance & Settlement Solutions
Medicare Set Asides represent more than 40% of total submitted workers’ compensation settlement costs.1 For claims that require Medicare compliance, it’s important to work with a company that has experience in medical cost management and can provide a structured process for adhering to the Medicare Secondary Payer (MSP) Act. Rising’s skilled experts have experience following changing regulations and making MSP compliance activities easy for all settlement stakeholders.
Leveraging our vast medical bill database, deep data intelligence, and automated technologies, we provide the historical insight needed to develop future medical cost projections that are defensible and necessary for MSP adherence.
Our comprehensive suite of solutions address medical costs and MSP compliance throughout the settlement lifecycle. They include:
- Pre-Settlement Cost Mitigation
- Medicare Status Checks
- Social Security Benefit Determinations
- MMSEA Section 111 Mandatory Insurer Reporting
- Medical Cost Projections
- Chronological Bill, Medical & EOR Records for Payer’s MSA Allocation Partner
- Post-Settlement MSA Administration Services
Early Invention Key to Successful Settlement Outcomes
Very few MSAs are submitted in the same year as the accident.2 While claims are under active management, pre-settlement medical costs can have a dramatic multiplying effect on the overall settlement value. Rising provides a full spectrum of solutions for managing these pre-settlement costs. Our medical bill review, clinical intervention, and pharmacy review services not only result in more effective care for the injured party, they also provide significant savings over the life of the claim.
Compliance & Cost Savings
Rising’s Medicare settlement solutions are available individually or bundled together. Talk to us about your claim needs and we’ll guide you through recommended best practices for achieving compliance and cost savings. For more information, contact info@risingms.com.
1,2 NCCI. Medicare Set-Asides and Workers Compensation: 2018 Update Arnautovic, Nedzad. February 5, 2018.
