Santa Clara, CA – CLARA analytics recently announced a new feature of its CLARA claims product that provides Medicare Set-Aside Arrangement (MSA) services faster and at vastly reduced costs. The data-driven MSA solution enables CLARA claims users to compile a much richer, more detailed analysis of estimated future medical costs for injured workers — all at the push of a button.
The CLARA claims MSA feature was developed to address a significant need in the market. While MSAs are designed to provide an estimate of future medical treatment costs for injured claimants to protect Medicare’s interests at claim settlement, obtaining an MSA can be a time-intensive process that often takes weeks, requiring numerous back-and-forth emails with the vendor as well as hefty fees. Currently, payers spend hundreds of millions of dollars annually on acquiring MSAs and expend significant resources when their adjusters become bogged down in this process. CLARA’s MSA solution changes this in a remarkably effective way.
The new MSA feature is fully integrated within CLARA’s AI-based claims product, which helps teams mitigate claim costs by identifying claims that are at risk for litigation or delays. All customers of CLARA’s claims suite can receive the MSA feature incorporated into their CLARA suite product pricing. CLARA’s MSA solution provides:
- Automated identification of claims likely to need an MSA based on claim attributes
- Automated MSA report generation at the push of a button
- Ability to combine/separate multiple claims to assess cost differences
- Updated reports as often as needed based on changing treatment under the claim
- Push-button inclusion/exclusion of body parts and comorbid conditions at time of MSA generation
- Availability in traditional CMS and EBM-based formats
- CMS submission of final MSA, with amended reviews where indicated
“At CLARA, our goal is to help claims teams reduce loss costs with easy-to-use AI,” said Kimberly Wiswell, vice president, managed care operations, at CLARA analytics. “While we’re not a direct competitor in the MSA market because we don’t ‘sell’ MSAs, we’ve developed this MSA solution as part of our artificial intelligence/machine learning-based suite of products. We believe this MSA solution, provided at no additional cost, will revolutionize the market.”
Source: CLARA analytics