It is undeniable. Medicare Secondary Payer (MSP) issues have become more and more complex over the last 25 years. They have also made handling liability, no‐fault, and work comp claims more and more difficult and costly. These are the reasons why Flagship Services Group came to exist.
Flagship assists liability, no‐fault, and work comp payers to navigate MSP situations, providing insurers, self‐insureds, and third party administrators specifically tailored services and products to successfully process all components of MSP compliance, especially resolution of conditional payments. Medicare compliance for property and casualty insurers, third party administrators, and self‐insureds is our sole focus.
We are experts in conditional payments resolution. It is what we do every day, all the time, on every case. Based on our years of experience resolving thousands of conditional payment claims, we have created our very own lien resolution process, built a one of a kind claims processing system, and put together the most amazing, dedicated and talented staff of claims specialists, and medical and legal professionals with years of experience handling Medicare and Medicaid conditional payments.
What follows are results from our 2017 annual study of the last 12,744 liability, no‐fault, and work comp conditional payment claims that we processed, resolved, completed, and closed. Our study shows Flagship was able to:
We handle all types of claims. Of the 12,744 cases we processed, resolved, completed, and closed, 7,141 were liability cases (56.0%), such as auto, medical malpractice, products liability, nursing home, and home owners cases. 5,270 were no‐fault cases (41.4%), such as auto no‐fault, med pay, and personal injury protection claims. 333 were work comp cases (2.6%), including state and federal work comp, and longshore harbor claims.
Taking into consideration all 12,744 cases handled, the $41.2 million total conditional payments requested by CMS, and the $27.6 million in total savings, on average, Flagship has saved its clients 67% of the initial CMS request for reimbursement (55.5% on 7,141 liability cases, 87.7% on 5,270 no‐fault cases, and 77.7% on 333 work comp cases).
Of the 12,744 liability, no‐fault, and work comp conditional payment cases Flagship processed, resolved, completed and closed, 5,866 (46%) had no conditional payment amounts. The remaining 6,878 cases (54%) had conditional payments. 3,615 cases (28.4%) had conditional payments between $1 and $1,000, 2,310 cases (18.1%) had conditional payments between $1,001 and $10,000, and 953 cases (7.5%) had conditional payments over $10,001.
In the 6,878 liability, no‐fault, and work comp claims in which Flagship was able to assist its clients in reducing conditional payments, the average conditional payment requested by CMS was $5,989.75. After Flagship reviewed, analyzed, disputed, and appealed such payments, CMS ultimately reduced its demand to an average of $1,977.48, thereby saving our liability, no‐fault, and work comp clients an average of $4,012.27 per case (average of $4,728.94 in 3,896 liability claims, $4,285.10 in 2,837 no‐fault claims, and $6,431.17 in 145 work comp claims).
Our conditional payment services pay for themselves. After fees, Flagship liability, no‐fault, and work comp clients still saved a total of $21,148,067 ($10.9 million in liability cases, $9.5 million in no‐fault cases, and $.75 million in work comp cases).
Flagship liability, no‐fault, and work comp clients have enjoyed an unmatched return on investment. On average, Flagship’s unparalleled return on investment to its clients was 328% based on net savings to total fees (an average of 301% ROI on 7,141 liability cases, 361% ROI on 5,270 no‐fault cases, and 387% ROI on 333 work comp cases).
Flagship Services Group is the premier Medicare and Medicaid compliance services provider to the property & casualty insurance industry. Our focus and expertise has been and remains the Medicare and Medicaid compliance needs of P&C insurers, third party administrators, and self‐insureds. We specialize in P&C mandatory reporting, conditional payment resolution, and set aside allocations. Whether auto, liability, no‐fault, or work comp claims, we have assembled the expertise, experience and resources to deliver unparalleled MSP compliance and cost savings results to the P&C industry.
"Flagship has been instrumental in helping us become Medicare compliant and their expertise in lien reductions has saved us millions. They offer peace of mind, extraordinary knowledge and true professionalism that have delivered unbelievable results."
- Claim Manager
Our Mutual Insurance Company is very pleased with the Medicare compliance services provided by Flagship Services Group based on the work they have done for us over the past two years.
Flagship has been a great solution to a difficult Medicare dilemma for us!
- Casualty Claims Manager