Verisk Analytics, Inc. · NASDAQ:VRSK
Verisk Analytics — Investor Presentation (January 2020)
26 slides from Verisk Analytics's investor presentation, Jan 14, 2020
Slide 1: Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Recovery Town Hall
Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Recovery Town Hall January 14, 2020
Slide 2: Presentation Overview
Presentation Overview • Conditional Payment Notice (CPN)/Conditional Payment Letter (CPL) • New Pre-CPN Worksheet • Disputes • Demand Letter • Interest • Appeal Timeframe • NGHP Open Debt Report • Contacts • References • Questions and Answers 2
Slide 3: NGHP CPN/CPL
NGHP CPN/CPL • The CRC will issue a Conditional Payment Notice (CPN) or a Conditional Payment Letter (CPL) when Medicare is notified that an applicable plan has or may have primary payment responsibility for an illness, incident, or injury and Medicare has made conditional payments. • The CPL will b
Slide 4: NGHP CPN/CPL, Cont.
NGHP CPN/CPL, Cont. • The CPN: • Includes conditional payment information noting items or services Medicare has paid conditionally. • Explains how to dispute any items and/or services included. • Should the applicable plan wish to dispute any of the payments before the demand letter is issued, the d
Slide 5: Pre-CPN Worksheet
Pre-CPN Worksheet • The CRC is introducing a new Pre-CPN Worksheet to assist Responsible Reporting Entity (RRE) Account Managers (AM) in managing their CPN workload. • The data on the Pre-CPN Worksheet will contain cases that have been reported. In some instances due to the timing of when a report i
Slide 6: Pre-CPN Worksheet, Cont.
Pre-CPN Worksheet, Cont. • Requests for the Pre-CPN Worksheet can be sent to [email protected] once a quarter. The RRE AM must provide the TIN and RRE ID(s) at the time of the request. • Completed Pre-CPN Worksheets can be returned to [email protected] via the secure em
Slide 7: Disputes
Disputes • Applicable plans: • May dispute the CPL or CPN. • Will have one opportunity to dispute a CPN before a demand letter is issued. The dispute must be submitted by the response due date to allow review before the demand letter is issued. • The CRC will review and evaluate the dispute (if rece
Slide 8: Documenting Disputes
Documenting Disputes • To facilitate the CRC’s review, disputes should include an explanation and documentation, as appropriate. • Payment ledgers are a type of documentation that can be used to support an applicable plan’s dispute. A payment ledger should include: • Date of service • Billed amount
Slide 9: Demand Letter
Demand Letter • If no dispute is received following a CPN, or a dispute is received and the recovery case still contains one or more medical claims, the demand letter will be issued to the applicable plan. • The demand letter will include: • Basic information regarding the recovery case. • An explan
Slide 10: Interest
Interest • Interest on the debt accrues from the date of the demand letter and if not resolved within 60 days, it is assessed for each 30-day period the debt remains unresolved. • Payments made are applied to the interest first and then the principal balance. • Interest continues to accrue on the ou
Slide 11: Appeal Timeframe
Appeal Timeframe • When CMS issues a demand letter directly to the applicable plan, the applicable plan has formal administrative appeal rights. • The applicable plan has 120 days from the date the applicable plan receives the demand letter to file an appeal. Interest will still accrue during this t
Slide 12: Contacts: CRC vs BCRC
Contacts: CRC vs BCRC • The CRC handles recovery when the applicable plan is the identified debtor. This includes cases of Ongoing Responsibility for Medicals (ORM). • You should always contact the contractor from whom you received the correspondence. • At anytime during the ORM and settlement proce
Slide 13: NGHP Open Debt Report
NGHP Open Debt Report • A report is now available in the MSPRP of all cases where an NGHP insurer is the debtor and where there is a balance due to CMS. • Account Manager users in MSPRP have access to create and view the Open Debt Report directly in the application. • The Open Debt Report is only av
Slide 14: NGHP Open Debt Report (2)
NGHP Open Debt Report (2) • Access the Welcome! Page and click the link for “Open Debt Report.” • Remember, only Account Managers have access to this report. 14
Slide 15: NGHP Open Debt Report (3)
edict NGHP Open Debt Report (3) Open Debt Report SD rac sts page Help About This Page (Ciick Search to return up to 1000 Cases, okdest to newest, or enter a Demand Date range to limit the cases retuned From Demand Date: ! ! ‘To Demand Date: U ! (Search) Selecting Cancel will return to the Welcome! p
Slide 16: NGHP Open Debt Report (4)
NGHP Open Debt Report (4) • The following fields are included in the report. Use the scroll bar at the bottom of the screen to view additional columns and at the side to view additional Cases. • Case ID • Insurer Name • Insurer TIN • RRE ID • Recovery Agent/TPA Name • Bene First Name, Beneficiary La
Slide 17: NGHP Open Debt Report (5)
NGHP Open Debt Report (5) • Rows display in ascending Case ID order. • Click Export to Excel to export your report to an Excel Spreadsheet. • Click Cancel to return to the Welcome! page. 17
Slide 18: Contacts
Contacts Topic Who to Contact Contact Information Case specific recovery CRC Contact Center 1-855-798-2627 (TTY/TDD: 1-855-797- 2627 for the hearing and speech impaired). After selecting your language preference, select “4” to reach the CRC queue. MSPRP account set- BCRC EDI Dept 1-646-458-6740 up/m
Slide 19: Resources
Resources • MSPRP User Guide • MSPRP Training Material • [email protected] 19
Slide 20: Questions & Answers
“COBR~—t—“‘(C‘; CS Coordination of Benefits and Recovery Questions & Answers 20
Slide 21: CRC NGHP Recovery Town Hall Slide Notes
CRC NGHP Recovery Town Hall Slide Notes Slide 1: Commercial Repayment Center (CRC) Non-Group Health Plan (NGHP) Recovery Town Hall Welcome to the Non-Group Health Plan Commercial Repayment Center Recovery Town Hall. Slide 2: Presentation Overview This presentation is intended to discuss Medicare’s r
Slide 22: CRC NGHP Recovery Town Hall Slide Notes
CRC NGHP Recovery Town Hall Slide Notes CPL: • Includes the same information as the CPN • Does not have a specific response due date and is not automatically followed by the demand letter. Slide 5: Pre-CPN Worksheet Now that we have discussed the purpose of the CPN in more detail we would like to in
Slide 23: CRC NGHP Recovery Town Hall Slide Notes
CRC NGHP Recovery Town Hall Slide Notes Slide 8: Documentating Disputes Accurate documentation of disputes will help facilitate a timely review. Payment ledgers are a type of documentation that can be used to support an applicable plan’s dispute. A payment ledger should include: Date of service Bill
Slide 24: CRC NGHP Recovery Town Hall Slide Notes
CRC NGHP Recovery Town Hall Slide Notes Slide 12: Contacts BCRC vs. CRC There can be some confusion about who may be handling an NGHP recovery case, so we wanted to clarify about the difference between the CRC and BCRC. The CRC handles reported recovery when the applicable plan is the identified deb
Slide 25: CRC NGHP Recovery Town Hall Slide Notes
CRC NGHP Recovery Town Hall Slide Notes Slide 18: Contacts Here are some quick references for who to contact. Also remember that additional contact information including phone numbers, mailing addresses and fax numbers are available on the Contacts page of CMS.gov Slide 19: Resources Lastly, we want
Slide 26: Acronyms
CRC NGHP Recovery Town Hall Slide Notes Acronyms AM Account Manager CPL Conditional Payment Letter CPN Conditional Payment Notice MSPRP Medicare Secondary Payer Recovery Portal NGHP Non-Group Health Plan ORM Ongoing Responsibility for Medicals QIC Qualified Independent Contractor RRE Responsible Rep
Verisk Analytics — Investor Presentation (January 2020) on 6ix