2018 Innovation Awards: Analytic-Powered Medicare Set Aside and Analytic-Powered Medical Reserve


Care Bridge International Inc.
While calculating Medicare set-asides and medical reserves is an important part of the workers’ compensation claims process, it has been historically complex and time-consuming, according to Deborah Watkins, CEO of Care Bridge International Inc. in Sarasota, Florida.

The process is used to calculate the funds needed to pay for future health care related to injury to workers who must be depleted before Medicare pays for treatment. The regulations cover the future obligations of a wage-bearer, but may include estimates that cover treatment costs for years.

Traditionally, demand experts offer a proposed arrangement to the Medicare and Medicaid Services Centers for review and approval.

Wat We’ve provided this prediction using a methodology that has never been proven, i says Ms. Watkins, a former clinical nurse who made medical claims throughout her career.

Companies that offer the regulations said they rarely do research to determine if the agreed amount is the right number. In addition, the process takes weeks to complete.

By adopting a large data approach to assess future medical costs, Watkins can rapidly produce lower and more accurate cost calculations than traditional methodologies.

Software solutions – Analytical-Powered Medicare Set Aside and Analytical-Powered Medical Reserve – won a 2018 Business Insurance Innovation Award.

Using a data warehouse with more than 12 million requests du a third-party administrator, carrier, own insured or a law firm, can perform a data integration request using a drop-down menu to answer questions, and we find similar claims of variable data warehouse and reasonable and probable future maintenance we can use the estimated models to provide analysis. analiz

Watkins returned almost half of the cost of the traditional reports, and claims could be resolved more quickly for months.

In addition, the data can be used to create an analysis panel that allows users to set up an assessment criterion and identify problems to monitor compliance and to monitor and measure reserves in real time.

Due to the speed of the response, users can obtain valuations while mediating claims. In addition, the product can be used to verify the existing reports, Ms. Watkins.

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