Make a Referral

 Knowledge Series

During these complimentary sessions, you’ll hear from our experienced team on a variety of forward-looking Medicare Secondary Payer (MSP) related topics with a focus on offering insights that help you stay informed and stay ahead – of both compliance requirements and your competition.

Completed Webinars
Please email us for the password needed to access each recorded session.

February 8 What Do I Need to Know About Section 111 Reporting?
Section 111 Reporting is a central part of Medicare Secondary Payer compliance. Mistakes in reporting ORM, ORM Termination, TPOC, ICD-Coding and other data can not only impact conditional lien exposure, but also may soon subject you, or your customers, to Civil Monetary Penalties.Key takeaways:

    • Gain an understanding of what is necessary for proper Section 111 Reporting
    • Explore things you can do now to help prevent inflated conditional liens and potential penalties in the future
February 22 This Case Won’t be Able to Settle: How Can I Lower MSA Costs?
Future settlement values are too often overinflated due to unclear documentation, inclusion of unwanted treatment(s), inclusion of high-dollar medications, and a variety of other reasons. We will discuss CMS’ policies, review claim mitigation strategies, and explore how to achieve mutually agreeable resolutions for you and the opposing party. We will provide several examples of ways to lower future medical projections and/or reduce the risks associated with the CMS submission process.Key takeaways:

    • It is highly important to understand the CMS methodologies that lead to large counter opinions.
    • You can develop and execute strategies that result in increased certainty in the CMS review process.
    • Being able to mitigate future medical pricing, even if not submitting an MSA to CMS, benefits both parties and facilitates settlement.
March 8 Exploring Different Processes for Medicare Liens: Parts A, B, C, and D
For traditional Medicare (Parts A and B), a specific process is used for conditional payment search and collections through Section 111 reporting information. However, the process may differ if a Medicare Part C or Part D plan is involved. Since Medicare has updated its query response system to include information from Medicare Part C and D plans, carrier/self-insureds now have a great opportunity to identify and resolve Medicare Part C and D liens prior to recovery litigation.Key takeaways:

    • Explore the lien process for the different parts of Medicare
    • Discuss how carrier/self-insureds can use Medicare’s query response system to effectively identify, track, and resolve conditional payments for all parts of Medicare.
March 22 Can I Do Anything About My Result from CMS or am I Stuck?
So, you submitted an MSA to CMS for review and received an unfavorable result, possibly impacting your settlement indefinitely. Are you stuck with their decision, or do you have options to pursue? Join us to explore the tools available for post-CMS review and how to set yourself up for success when requesting a Re-Review or Amended Review from CMS.Key takeaways:

  • Gain a better understanding of when a CMS approved MSA qualifies for a Re-Review, along with the limitations and benefits related to your request
  • Be able to identify CMS approved MSAs on file for unsettled claims that may qualify for Amended Review
  • Review methods for bringing your case closer to the MSA number needed to achieve settlement
April 5 Is It True That Non-Submit MSAs Can No Longer Be Used?
In January of 2022, CMS released a new version of the WCMSA Reference Guide (version 3.5), adding section 4.3 The Use of Non-CMS-Approved Products to Address Future Medical Care. Some in the industry interpreted section 4.3 to mean you could no longer opt out of the CMS submission process. However, that is not the case. CMS followed with an updated version of the WCMSA Reference Guide, version 3.6, which confirmed that submission remains voluntary. We will walk through the facts and discuss where we stand on the age-old question – To Submit or Not Submit?Key takeaways:

  • Discuss existing statutes, regulations, and CMS guidance regarding submission of MSAs to CMS for review and determination
  • Explore the differences between submitted MSAs and non-submit options and discuss when Non-Submit MSAs can be an effective tool to close cases
April 19 Is CMS Still Approving Zero Waiver MSAs?
In this webinar, we will explore considerations for Zero Waiver MSAs including examining the language and documentation required by CMS, discussing clean cases where no loss payments were made, and assessing the best methods for disputing Zero Waiver MSAs.Key takeaways:

  • Understand when and how MSA Waivers can be submitted to CMS
  • Determine when to use a Non-Submit Zero MSA to help with settlements on denied claims that are not reviewable by CMS
  • Review the steps needed to secure an elusive Zero Waiver MSA with CMS

Your Presenters

    

Bridget Smith
Sr. VP, National Accounts
and Settlement Consulting

 Jennifer Shymanski  

Jennifer Shymanski
Vice President,
Implementation and Strategy
 

Jennifer Mislanovich
Vice President,
Settlement Consulting
 

Mark Heberling
Vice President,
Settlement Consulting
 

Patrick Czuprynski
Director,
Lien Resolution
 

Dawn Dietz
Assistant VP,
Settlement Consulting

Explore Our Blog

Beyond our knowledge series, our teammates regularly provide observations on the
latest industry news, offer analyses of CMS policy decisions, and deliver valuable
insights on MSP news while keeping our readers informed.

Learn More