Compliance Basics

WCMSA Screenshot

2024 Medicare Set-Aside Trends

For Insurance Adjusters: Why This Matters to You Insurance Adjusters, these Medicare Set-Aside trends directly impact your work in claims settlement and risk management. Understanding these developments is crucial for accurately estimating future medical expenses and ensuring compliance with CMS guidelines. Your key takeaways should be the increased scrutiny on prescription drug allocations, the need […]

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Avoiding Penalties, Compliance Basics, Medicare Set-Asides (MSAs)
Medicare Set-Aside

The Medicare Set-Aside (MSA)

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

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Compliance Basics, Medicare Set-Asides (MSAs)
Risk Manager talking Section 111 Reporting

Section 111 for Risk Managers

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

Medicare Beneficiaries

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:

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Compliance Basics
Picture of Glossaries

Medicare Compliance Glossary

This comprehensive Medicare Compliance Glossary is an essential resource for insurance adjusters and risk managers navigating the complex world of Medicare compliance. Tailored specifically to the needs of insurance professionals, it breaks down crucial terms, processes, and concepts into clear, practical explanations. From understanding various types of Medicare Set-Asides to grasping the intricacies of Section

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Compliance Basics, Tools & Resources
Insurance Claim Form

Assessment of Damages

As insurance adjusters and risk managers, our primary responsibility is to accurately evaluate and settle claims. At the heart of this process lies the assessment of damages – our bread and butter. However, when dealing with Medicare beneficiaries, this crucial task takes on added layers of complexity and importance. In this article, we’ll explore why

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Compliance Basics
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