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The CMS Recovery Portal: helping put money in your pocket faster

December 2, 2015 by Brian Schachter Leave a Comment

ess- medicareEarlier this month, the Centers for Medicare and Medicaid Services (CMS) published a long-awaited update and clarification on the conditional payment process for the Medicare Secondary Payer Recovery Portal (MSPRP or Recovery Portal). This is a significant development for us and our clients and the broader community of the plaintiffs’ bar because it affects the timeline and best practices that should be followed in resolving any case where Medicare has rights to receive reimbursement from the settlement proceeds.

CMS has been working for several years now to develop the Recovery Portal as a means for expediting the resolution of Medicare lien claims. Chronic delay from the Medicare bureaucracy in determining the final reimbursement amount has long been a cause of considerable frustration for plaintiff’s attorneys.

[Read more…]

Filed Under: lien resolution, Medicare Tagged With: lien resolution, Medicare, Medicare Liens

The Deadline Looms for New Medicare Billing Codes

September 22, 2015 by Brian Schachter Leave a Comment

We’ve written before on the blog about the looming revisions to the Medicare billing codes, which are about to expand almost ten-fold from the 17,000 current treatment codes to more than 155,000 treatment codes under the new scheme. This issue is in the news again because the new coding scheme, referred to as ICD-10, is set to go into effect in less than 2 weeks on October 1st. (Click here to read our prior blog post.)

Medicare codingThe New York Times recently ran a story about the significant impact the new coding scheme is likely to have on the medical profession, describing it as “a sea change for physicians”. Apparently, the pending changes are triggering extensive anxiety among doctors as a result of the anticipated the difficulties of compliance and the disruption it’s expected to cause in revenue and cash flow. The article highlights some extreme examples of the new coding scheme, such as the requirement for doctors to specify a distinct code depending on whether a patient was bitten by a horse, a shark or a crocodile (newly designated as Code W58.13) or suffered injury as a result of being sucked into a jet engine (new code V97.33). In a somewhat more serious vein, the article also reports how doctors groups are scrambling to line up new lines of credit on the assumption that confusion and non-compliance are going to result in extensive payment delays. (Click here to read the full story in the Times.)

[Read more…]

Filed Under: lien resolution, Medicare, Uncategorized Tagged With: lien resolution, Medicare Liens, medicare set asides

155,000 Reasons Why Lawyers Should Consider Outsourcing Medicare Lien Resolution

March 16, 2015 by Randy Levine 1 Comment

medicare lienIf your law firm still handles Medicare lien resolution in-house, there are now 155,000 reasons for you to consider looking for a new solution. That’s because later this year Medicare is rolling out sweeping revisions to the billing codes that must be used in connection with Medicare reimbursement and lien-related work.

The Medicare bureaucracy is often reviled for its complexity and inefficiency. Well, it’s about to get a whole lot worse. As of Oct. 1, 2015 the ICD-9 codes, which have been in use since 1975, are going to be replaced with the next generation, ICD-10. The change over entails an exponential increase in complexity, moving from the 17,000 treatment codes covered by the current ICD-9 scheme to as many as 155,000 treatment codes possible under ICD-10. As Medicare explains it, the massive overhaul is necessary to ensure more accurate billing and to better reflect the full range of technology, diagnoses and procedures used in hospitals today.

This means that hospitals have to modernize EVERYTHING relating to their billing systems and procedures. The billers have to be retrained, the computers have to be upgraded and no, this won’t come cheap. The President-elect of the American Medical Association, Steven J. Stack called the change “a massive unfunded mandate that comes at a time when physicians are trying to meet several other federal technology requirements and risk penalties if they fail to do so.” [Read more…]

Filed Under: Law Firm Management, lien resolution, Medicare Tagged With: Health care, ICD-10, ICD-9, lien resolution, Medical Law, Medicare, Medicare Liens

The Value of Partnerships

March 3, 2015 by Brian Schachter Leave a Comment

ski

We at ESS Settlement Services are extremely careful about identifying and selecting the companies we choose to partner with. When we partner with someone, we make sure they are the best at what they do and also that they share the same client centric culture that is core to our mission. One of our partnerships makes us so happy that we want to shout it from the top of a mountain! Actually, we did. Atop Mt. Keystone in Colorado we couldn’t help laughing about living our motto “Above and Beyond,” literally.

It was to the mountaintop we went last month to meet (and enjoy ourselves) with Providio Medisolutions, our partner that provides our clients with expert lien resolution services. As many of you know, lien resolution can be a problematic and painful process that many lawyers would prefer to avoid handling themselves. So we made it a priority to find the best possible lien resolution partner, enabling us to help our clients deal with this time consuming but critical process.

As a growing business, we’re focused on forging partnerships that add the most value to our clients. We know our strengths and where we excel. Issues outside our core competencies are better handled by partnering with “best in class” providers like Providio. Throughout our week in Colorado, we spent a significant amount of time in meetings with Providio’s sales and service experts, cementing the relationship. However, it was in a more informal setting, where we really felt the synergy between our two companies. We discussed our shared values over beers at dinner, and then enjoyed some live music on Thursday night. Friday ended up our most productive day; we spent it skiing! Without our phones and other distractions, we talked and worked nonstop, while having fun! As far as business trips go, this one went “above and beyond” our expectations.

Filed Under: lien resolution, Medicare, strategic partners Tagged With: law, lien resolution, Providio, strategic partners

Recent Posts

  • ABLE Accounts: providing a better life experience for New York’s disabled residents
  • Bringing Your Client to Mediation: the pros and cons considered
  • How To Identify Which Cases Are Ripe For Mediation
  • The CMS Recovery Portal: helping put money in your pocket faster
  • Getting the Most of Out of Your Next Mediation

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  • ABLE Accounts: providing a better life experience for New York’s disabled residents
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