Section 111 Reporting

With business process management baked into our technology, the Tower MSP Automation Suite and its S111 Management Dashboard ensures 100% MSP compliance.

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Ensures Compliance

Data Integration

End-to-End Visibility

Secure Dashboard

Audit Trail

Pre
Validation
Checks 0

Activities
& Processes
Monitored 0

Point of Contact
for Conditional
Payments, S111, & MSAs 0

FEATURES & BENEFITS

Ensures 100% MSP compliance
24/7 visibility via secure dashboard to manage claims data
Reports available on the fly to resolve any compliance issues
Easily integrates with any claims system, even older legacy systems
Provides timely, complete and accurate reporting
Provides secure data transfer – manual and electronic data feeds
Delivers clear, comprehensive compliance reports
Enables efficient management of queries, reporting, and conditional payment analysis
Produces audit-ready trail of all Section 111 actions and continuous data audits
Captures, stores and manages all data points in paperless environment
Supports automated CP negotiation service when CPNs are received
Provides end-to-end visibility of claim demographics, ICD10 codes and Medicare eligibility information to pre-populate conditional payment negotiations and Medicare Set-Asides

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TECHNOLOGY DRIVEN MSP COMPLIANCE

CASE STUDY: CONDITIONAL PAYMENT

PDF case study MSA Conditional Payment results

CHALLENGE

Conditional Payment Notice submitted to Tower for potential dispute. Charges identified by the CRC included multiple hospital stays, ER visits and surgeries, as well as treatment by unauthorized treating physicians.

SOLUTION

Tower's CP specialist first confirmed date of injury, accepted body parts and the approved ICD10 codes as reported via Section 111 ORM for the assigned claimant. We then requested and obtained all medical records for dates of service identified by the CRC for recovery.

RESULT

No Interest letter to confirm that the services were appropriately paid by Medicare. Total savings = $71,349.

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CASE STUDY: SECTION 111 MANDATORY INSURANCE REPORTING

PDF Case study section 111 reporting results

CHALLENGE

A self-insured self-administered employer was utilizing the Section 111 Mandatory Insurance Reporting system of a national MSP vendor. The employer was interested in having a greater end to end visibility into their claims. They wanted more than a vendor with a system; They wanted a partner with solutions.

SOLUTION

The employer selected Tower MSA as their MSP compliance partner. Upon integration of the employer’s data files, Tower’s system analyzed their past data as well as the current data files. Tower noticed a steady uptick pattern in files with ORM (Ongoing Responsibility of Medical) remaining open even after TPOC (Total Payment of Claim) had been checked.

RESULT

RM impacts current and future exposure of Medicare’s Conditional Payment demands for reimbursement. Accurate reporting is critically important in mitigating exposure.

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Tower MSA Partners took the complexity and mystery out of the MSA process for CPC Logistics and our TPA. They’ve been instrumental in leading us to properly structure our program for success related to MSAs, both now and in the future.

Anne Alabach, CPDM
Workers Compensation Department Manager
CPC Logistics Inc.

Section 111 Reporting

FEATURES & BENEFITS

TECHNOLOGY DRIVEN MSP COMPLIANCE

CASE STUDY: CONDITIONAL PAYMENT

CHALLENGE

SOLUTION

RESULT

CASE STUDY: SECTION 111 MANDATORY INSURANCE REPORTING

CHALLENGE

SOLUTION

RESULT

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