Medicare Conditional Payment Management
A Conditional Payment (CP) occurs when Medicare has paid for health care services provided to a Medicare beneficiary, but a primary payer exists who is responsible for those payments.
Medicare makes such payments on condition that reimbursement will be made to Medicare if the primary payer provides any compensation to the Medicare beneficiary (i.e. settlement, judgment, award, other).
Flagship saves P&C insurers millions of dollars annually in Medicare reimbursements by reducing the aggregate Conditional Payment Demand amounts.
- Flagship removes the Medicare headache from adjusters’ desks so they don’t have to be experts in the world of ever-changing Medicare regulations.
- Flagship enables claim adjusters to spend their time doing what they do best, closing the 85%-90% of claims that are non-Medicare related.
As a Conditional Payment Company we offer 100% Medicare Compliance
- End-to-End Solutions
- Mitigation of Medicare penalties by resolving all Conditional Payment liabilities.
- Protection of client’s financial resources by reducing Conditional Payment reimbursement amounts to the lowest defensible amount…and not a penny more!
- Simplification of Medicare compliance for claim adjusters by reducing their Medicare duties to a couple of basic steps – transmission of Medicare claims to Flagship at the front end, then filing Medicare closure documents at the back end.
- Management Reports
- Monthly Management Report that includes claim referral volume, Conditional Payment demands, fees, net savings, and ROI. Report, tracked by claim adjuster, can also be expanded to include individual claim offices and regional results.
- 100% Compliance guarantee when all Medicare and Flagship policies and procedures are followed.
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- Civil Money Penalties (2/17/2020) - The Centers for Medicare and Medicaid Services (CMS) is set to release their proposed rulemaking for Civil Money Penalties (CMP’s) regarding Medicare reporting. CMS is expected to publish the proposed rule on Tuesday, February 18, 2020 and is accepting public comment for 60 days. The deadline to submit comments will be Monday, April 20, 2020. […]
- Robert J. Finley to Present at 5th Annual RISE Medicare Secondary Payer Master Class (1/29/2020) - Robert J. Finley, Partner with Hinshaw & Culbertson LLP and Chief Legal Consultant to Flagship Services Group, will provide a series of presentations at the 5th Annual RISE Medicare Secondary Payer Master Class, to be held February 3 – 4, 2020 in Jacksonville, Florida. The comprehensive two-day event is designed for mid to senior level management and legal professionals who are responsible for Medicare Secondary Payer compliance in risk management, finance, enforcement, and legal roles.