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05 November 2014
London
Reporter Stephen Durham

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New partnership yields Medicare compliance service

Xchanging has partnered with Gould & Lamb, a provider of Medicare compliance services to the global insurance and self-insurance marketplace.

The alliance will allow insurers to check and report on US Medicare eligible claimants to the Centre for Medicare Services (CMS).

All insurers, irrespective of location, are currently required to report to CMS if a US citizen is potentially Medicare eligible and suffers injury through fault of that insured.

The individual does not have to reside in the US, nor does the injury have to occur in the US for them to be Medicare eligible.

Xchanging has claimed insurers who are not currently reporting correctly, or who are not reporting at all, “may be exposed to heavy fines and recovery action”.

CMS has the authority to fine insurers internationally for non-reporting compliance up to $1000 per claim, per day.

Xchanging has stated that its Medicare Reporting Service, developed in partnership with Gould & Lamb, will lead to a “significant reduction” in the amounts payable to CMS through decoupling of unrelated health claims

Kerry Rainer, head of service for Xchanging claims services, commented: “We are delighted to announce that we are working with Gould & Lamb to provide a new way for insurers to report eligible claims to the US Medicare Authority and to offer a full Medicare reporting service to our customers.”

“Backed by a leading team of professional adjusters with a proven ability in claims handling and service delivery, this service sits at the heart of our portfolio and offers an efficient and innovative solution to our clients.”

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