MedInsights Establishes Medicare Secondary Payor Compliance Unit and Launches Medical Benefit Accounts Product

FRANKLIN, Tenn., April 29 /PRNewswire/ -- MedInsights, Inc., a leading provider of managed care and rehabilitation services, today announced the establishment of a Medicare Secondary Payor Compliance & Resolution Unit and launched a new tool to aid TPAs and self-insured companies in the resolution process -- a Medical Benefit account (MBA). MedInsights' new unit and product will help stretch medical settlement dollars as well as reduce or eliminate exposure to Medicare violations.

"New federal regulations and penalties take effect in July 2009," said Paula Woolworth, Vice President of MedInsights, Inc. "We can help companies and third-party administrators comply with the law today."

Medicare Secondary Payor Compliance Unit

Insurers and employers have significant new legal responsibilities when identifying and settling workers' compensation and other liability or benefit cases. These responsibilities require reporting to Medicare and that future medical expenses be accurately forecast and approved by Medicare regulators, and that such settlements be allocated or "set aside" for future payment of such expenses. Obtaining that approval and maintaining overall compliance involves a complicated confluence of state and federal laws, and non- compliance can trigger significant fines, including new penalties that take effect July 1, 2009.

For any claim requiring future cost allocation, MedInsights conducts a thorough review of the case to determine the beneficiary classification, forecast anticipated costs, and ensure compliance with Medicare regulations.

"We have trained adjusters, nurses and certified life care planners who assure that clients' interests are protected through this service," said Woolworth.

To consider Medicare's interests, MedInsights' Compliance & Resolution Unit will work with a business partner to obtain a Medicare Set Aside (MSA) report where required. The Compliance & Resolution Unit also will complete future cost projection reports on cases not warranting a full MSA allocation report. Additionally, the Unit will oversee compliance and alternative funding options, such as structured settlements, for MSA accounts.

Medical Benefit Account

MedInsights will offer the use of a new Medical Benefit Account, post- settlement, to assist in stretching claim settlement dollars via bill review management system and by using medical network partners to obtain discounted products and services.

"This account will allow claimants to reap the rewards of bill reductions and negotiated medical service discounts," said Woolworth. "These savings could stretch a settlement by up to 40 percent by allowing the claimant the benefits of the above reductions."

MedInsights is featuring this new product at the Risk & Insurance Management Society's Annual Conference in San Diego this week. Additional information is available at GAB Robins' trade show booth (#2401) or via e-mail at [email protected]

MedInsights, Inc., a subsidiary of GAB Robins North America, Inc., is a leading provider of managed care and rehabilitation services. For more information, please visit

SOURCE MedInsights, Inc.