Medicare Set-Aside (MSA’s)
Mitchell ScriptAdvisor provides MSA solutions for workers’ compensation payers nationwide. CMS (Centers for Medicare and Medicaid Services) recommends that parties to a Worker’s Compensation settlement set aside funds for all future medical services related to the Worker’s Compensation injury or illness that would otherwise be reimbursable by Medicare. A Medicare Set-Aside Arrangement protects Medicare’s interests when settling future medical benefits for qualified individuals and prevents the shift of burden from the primary payer to Medicare.
MEDICARE SET ASIDE SERVICES:
Review of Medical Records
Review of Payout History
Breakdown of Medicare and non-Medicare costs
Based on CMS guidelines
MSA SUBMISSIONS SERVICES:
Send appropriate forms to claimant attorney, defense attorney and CMS, including SSA-3288, Medicare release of information form, and general release forms to verify Medicare eligibility and lien status.
Obtain and organize all information as per CMS guidelines
Transfer of files to CD-ROM format
Monitor and follow-up with the lead contractor on submission status until the file is approved by CMS.
CONDITIONAL PAYMENT LIEN RESOLUTION SERVICES:
Obtain information on conditional payments made from CMS
Audit for accuracy and send corrected list of claims to CMS
Obtain final payment demand from CMS
PMOA MEDICARE SET-ASIDE SERVICE COMMITMENT:
MSCC Professional Nurses complete MSA process to include on-going communication with client to move file to settlement
PharmD reviews and prices all prescriptions
Reports meet CMS requirements resulting in higher CMS Submission rate
10 day turnaround time
All MSA’s are one flat rate with NO HIDDEN FEES
NO CHARGE FOR RUSH CASES!