Allocation Report: A report following the format mandated by CMS that identifies Medicare covered services and costs that are projected to continue following a settlement of the claim;
CMS Submission: All documents as outlined by CMS are compiled and submitted for CMS approval of the amount of money projected as needed to satisfy Medicare’s interest.
Reporting
Effective July of 2009, all injury claims with a Medicare element are to be reported as early into the claim as this information is determined. PRO MED provides this reporting service.
Lien Search / Review / Negotiations
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Medicare may make inadvertent payments for treatment as a result of injury. Prior to settling an injury claim, it is required that this information be determined and that Medicare be reimbursed before the claim can be considered completely closed. PRO MED provides the contact to Medicare to obtain a report of any payments made.
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When Medicare identifies what they feel is treatment that was inappropriately paid by them, they provide this document and request payment. PRO MED reviews the document to determine if all looks like it is related to the claim and if not, will negotiate with Medicare to reduce the amount.
“In my workers’ compensation defense practice, Pro Med has repeatedly
provided comprehensive and accurate Medicare Set Aside evaluations
which consider Medicare’s interests but in a practical and
cost-effective manner to carriers. This is an important balance that I
believe Pro Med achieves, time and again, in their MSA evaluations.
Furthermore, I have always appreciated the efficiency with which Pro
Med has handles the MSA submission process.”
J. Matthew Mauldin, Esquire
“You exceed all my expectations. That’s why you’re the best.”
Frank Pittmann,
Workers’ Compensation Manager,
Toledo Ohio
“I use PRO MED for MSAs because of their ability to protect Medicare’s
interest without overfunding the MSA; while still getting CMS
approval.”
Tami Viebrock,
Workers’ Compensation Manager,
Cape Coral, Florida
"PRO MED provided excellent service to my client with the successful
reduction of a proposed MSA Trust by over 500K. Their commitment to
resolving this issue was outstanding and their relentlessness in dealing
with CMS was as impressive, if not more so, than any other similar
service provider I have encountered in over a decade of representing
employers and insurance carriers. Contact PRO MED when YOU are
considering a change in your Medicare compliance vendor!!"
Prominent Defense Attorney
Columbia, SC
The Official U.S. Government Site for People with Medicare
Centers for Medicare and Medicaid Services
Want to learn more? Interested in a proposal? Please contact us!