Services

Conditional Payments, Flagship Services Group

Conditional Payments

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.

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Medicare Set-Asides, Flagship Services Group

Medicare Set-Asides

There are many options when it comes to protecting Medicare’s future financial interests under the Medicare Secondary Payer(MSP) law. MSAs have evolved over the years as one such option. 

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Section 111 Reporting, Flagship Services Group

Section 111 Reporting

Flagship has created LumenX, a dedicated, fully integrated IT infrastructure to handle every aspect of Medicare Querying, Reporting and Conditional Payments.

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Medicare Risk Review, Flagship Services Group

Medicare Risk Review

Internal Medicare claims management is costly, time consuming and error-prone because the Federal regulations are complex and continuously changing.

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Legal Counsel, Flagship Services Group

Legal Counsel

Flagship's Rafael Gonzelez, Esq. provides decades of experience and in-depth legal knowledge to address the evolving challenges of Medicare compliance.

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Commercial Repayment Center, Flagship Services Group

Commercial Repayment Center

The Commercial Repayment Center (CRC) pursues recovery on claims where the insurer is the debtor: typically No-Fault and Workers’ Compensation claims. P&C Insurers often scramble to keep up. Flagship's proven process helps you overcome CRC challenges.

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Flagship Services Group is exclusively dedicated to Medicare compliance for P&C insurance carriers, self-insured companies, public entities, TPAs, attorneys and other Medicare compliance related parties.Through a superb team of claim specialists, nurses and attorneys, with exceptional knowledge and expertise in Medicare claims compliance, Flagship delivers unsurpassed results.

Flagship’s Medicare Compliance Services:

1) provide an analysis of Medicare compliance status;
2) protect client’s financial resources;
3) mitigate the risk of non-compliance penalties;
4) remove the Medicare claims headache from claim adjusters’ desks.


Flagship’s compliance solutions generally reduce cycle times, paid costs and company reserves.

SERVICE
DESCRIPTION
Area of highest Medicare compliance cost and risk for P&C insurers. Unique end-to-end process management and expertise ensures 100% compliance. We take Conditional Payments off adjusters’ desks to eliminate errors and delays, reduce reimbursement costs and increase adjusters' efficiency.
Flagship provides complete MSA creation and submission services, or MSA alternatives where appropriate. Medicare does not yet require MSAs for liability claims, but has announced its intention to do so. Flagship guarantees you will be ready when that happens.
LumenX®, Flagship’s proprietary reporting system, is the industry’s most robust, accurate, timely and easy-to-use Medicare query and Section 111 Reporting system
Review policies and processes for identifying and managing Medicare claims, and completing steps required to close a Medicare file and create an audit trail.
Medicare Essentials
Comprehensive session for claim professionals that provides understanding on the importance, training and best practices, of accurate and timely Medicare claims processing.
Account Management
Experienced, professional account manager and operations team dedicated to ensuring your compliance objectives are achieved.
Key Metric Reporting
We believe in, and practice, transparency and pro-active communication. Your adjusters will know the status of each file; your management team will have reports to track performance measures.
Trusted Medicare Advice
Whenever any of your claims team or senior management have questions or require claim-compliance advice, our professionals are available.