Hello, fellow adjusters! Sheryl Thompson here, your friendly neighborhood Medicare Set-Aside Nerd. Today, we’re diving deep into the world of Medicare Set-Asides (MSAs). Grab your coffee, settle in, and let’s unravel this complex but crucial aspect of our work. Our Comprehensive Guide to Medicare Set-Asides for Insurance Adjusters What is a Medicare Set-Aside (MSA)? Simply […]
The Medicare Set-Aside (MSA) Read Post »
Compliance Basics, Medicare Set-Asides (MSAs)
Hello again, fellow adjusters! Sheryl Thompson here, your Medicare Compliance specialist. It’s been several months since the 2024 WCMSA Update to the Self-Administration Tool Kit, and I’m still fielding questions about what it all means. So, I thought it was high time to revisit this topic, clarify a few things, and share some best practices
Section 111 for risk managers is crucial for ensuring your organization’s overall compliance with Medicare regulations. This guide to Section 111 Reporting for risk managers will help your organization navigate the complexities of Medicare reporting and collaborate effectively with your claims adjustment team. Section 111 for Risk Managers: A Comprehensive Guide by Sheryl Thompson Senior
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Avoiding Penalties, Compliance Basics, Medicare Reporting
As an insurance adjuster with over 15 years of experience in Medicare compliance, I’ve seen firsthand how Section 111 Reporting has transformed our industry. When I first encountered this topic, it seemed like an impenetrable wall of regulations and technical jargon. But over time, I’ve come to appreciate its importance and even find fascination in
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Medicare Reporting
As an adjuster, handling claims for self-insured clients using TPAs presents unique challenges and opportunities. This configuration differs significantly from traditional insurance arrangements, and understanding these differences is crucial for effective claims management. Adjusting Claims for Self-Insured Clients Using TPAs: Essential Guidelines by Sheryl Thompson Senior Claims and Compliance Specialist Here’s what you need to
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Best Practices, TPAs
Attention claims managers, insurance adjusters, and risk managers: The Centers for Medicare and Medicaid Services (CMS) has released the WCMSA Reference Guide v4.1, effective August 1, 2024. This latest version of the WCMSA Reference Guide brings significant changes that directly impact our day-to-day operations and long-term claim strategies. Let’s break down what you need to
WCMSA Reference Guide v4.1 Read Post »
Federal CMS Changes, Legislative Updates, Tools & Resources
As insurance adjusters and claims managers, staying abreast of legal developments that affect our handling of Medicare-related claims is crucial. A recent ruling by the United States District Court for the Eastern District of Michigan has significant implications for how we manage conditional payments and our reporting obligations. Let’s break down what this means for
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Avoiding Penalties, Legislative Updates
As insurance adjusters, one of our critical responsibilities is accurately identifying Medicare beneficiaries in our claims. This knowledge is crucial for ensuring compliance with Medicare Secondary Payer (MSP) regulations and avoiding potential penalties. In this article, we’ll explore the definition of a Medicare beneficiary and discuss best practices for determining beneficiary status. Understanding Medicare Beneficiaries:
Medicare Beneficiaries Read Post »
Compliance BasicsAbout Medicare Compliance Center Discover our mission to empower insurance adjusters and risk managers. Our Story The Medicare Compliance Center was born from a simple yet powerful vision: to create a one-stop resource for insurance professionals navigating the complex world of Medicare Compliance. Founded by industry veterans who understood the daily challenges faced by adjusters,
Empowering Medicare Compliance Professionals About Medicare Compliance Center MedicareComplianceCenter.com Your go-to resource for navigating the complex world of Medicare compliance in the insurance industry. Led by a team of seasoned experts including Sheryl Thompson, Dr. Amina Patel, Maria Rodriguez, and Olivia Chen, our website offers comprehensive, up-to-date information on Medicare Set-Asides, Section 111 reporting, and
