How MSP Recovery Impacts the Claims Management Process
Track
:
Claims and Litigation
Program Code:
TH-01
Date:
Thursday, October 14, 2010
Time:
9:15 AM to 10:15 AM
EST
Location:
Room 15/16
CO-PRESENTER
:
Clare Bello, President and CEO, Vertical Claims Management , LLC
Clare leads VCM, a nationally recognized claims and litigation management and consulting organization in the management of professional liability claims. In her role as CEO, Clare has focused on critical issues such as compliance challenges under MMSEA Section 111. She lectures in national and international programs aimed at the healthcare profession; is published for her innovative approaches to claims management and consulting services; and is active in organizations designed to develop and promote best practices for the management of claims and risk in the ART market.
VCM's claims program, the Vertical Advantage, have been exclusively endorsed by the AHA since 2003.
PRESENTER
:
Diane Wilkerson, National Healthcare Claims Consulting Team Leader, Marsh
Diane is a Senior Vice President with Marsh and leads their National Healthcare Claims Consulting team. She works with clients to optimize their claims management structure, process and technology. She also performs professional liability claims audits for adherence to best practices. During 2009 Diane took on the role of MMSEA Section 111 thought leader delivering reporting solutions and process support to clients. As a former med mal claims manager, Diane has experienced the MSP recovery process firsthand. In 2010 and beyond RREs will deal with the next phase of CMS compliance involving Medicare Secondary Payer recovery efforts.
Description
After the dust settles and RREs are reporting indemnity claim payments in compliance with Section 111 MMSEA, what is their next challenge?
Will RREs know how to modify their claims handling process to respond to the Medicare Secondary Payor Recovery Contractor's (MSPRC) reimbursement demand? Do RREs know how to obtain interim payment statements from the MSPRC to facilitate settlement? How does the recovery process impact RRE reserving? Will RREs protect Medicare's interest at the time of settlement as well as their own? All this and more with survival tools to prepare for the next MSP wave.
LEARNER OUTCOMES:
Determine if your claim management process protects Medicare's interests and your own.
Recognize the far reaching effects of the Medicare Secondary Payer (MSP) statute of 1980
Relate the impact of MSP recovery on your reserving and settlement activities.