Are You Correctly Identifying ALL Medicare Beneficiaries?

Posted by Kendell Gracey on Aug 28, 2014 6:03:00 PM

Medicare compliance for P&C insurers can be placed in three big compliance “buckets”:

  1. Identify all claimants who are Medicare beneficiaries
  1. Take care of Conditional Payment issues for each Medicare beneficiary identified
  1. Report each Medicare beneficiary claim to Medicare per Section 111
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Topics: Self-Evaluation, Beneficiaries

Medicare Compliance Self-Test

Posted by Kendell Gracey on Jun 6, 2014 11:32:00 AM

In the world of Medicare compliance for Property & Casualty insurers, it is difficult, but critical, to know where you are on the compliance spectrum.  Non-compliance can have serious consequences that range from financial penalties to unwelcome publicity.

The three “Ms” of Medicare non-compliance are “Myths”, “Misunderstandings” and “Mistakes." Many seem reasonable, sound believable, appear to be factual and often reinforce each other. However, Medicare regulations are based on complex government legislation that changes frequently.  That is what makes the myths and misunderstandings believable.  Most non-compliance is unintentional, but that response is generally inadequate when faced with financial penalties, a media story about to become a headline, or a job loss.

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Topics: Compliance, Self-Evaluation