Fast and Accurate Calculation of Medicare Set-Asides (MSAs)
We expedite the MSA calculation process and use our legal expertise to reduce MSA costs by developing legal strategies for avoiding inclusion of certain treatment in MSAs. Our goal is to get your case settled quickly at the lowest possible cost. Before making any CMS submission, we prepare a preliminary Medicare Set-Aside with a strategic legal analysis aimed at reducing the MSA amount and determining whether or not to submit to CMS, with a single goal – facilitating faster case settlement.
Strategic Submission of Applications to CMS for Pre-Settlement Approval
Our CMS applications are prepared and submitted with one goal in mind – quick approval to facilitate case settlement. As attorneys, we can provide you legal advice regarding whether you have fully protected Medicare's interests and whether NOT submitting of a proposed MSA to CMS for approval is the best option. This sometimes occurs where there has been no treatment for many years or where we believe that CMS will include treatment that our client has no legal obligation to pay.
Aggressive Resolution of CMS Conditional Payment and Medicare Advantage Plan Reimbursement Claims
Our firm researches and challenges conditional payment and Medicare Advantage Plan reimbursement claims on open files, as well as at times of settlement. We use our factual knowledge of the underlying workers' compensation claims and legal strategies based on workers' compensation law and federal law to creatively and successfully dispute reimbursement claims. We routinely handle all aspects of conditional payments, from disputes of notices and appeals of demands, through requests for review by the Qualified Independent Contractor, attendance at hearings before the Office of Medicare Hearings and Appeals, negotiation with creditors, and offsets by the Department of the Treasury. We also offer advice on Mandatory Insurance Reporting and other mitigation strategies to reduce conditional payment and Medicare Advantage Plan liability.
Resolution of Health Insurance Match Program (HIMP) Claims
We negotiate and dispute Health Insurance Match Program reimbursement claims from private health insurers. As lawyers, our in depth knowledge of the detailed rules and regulations that govern the Health Insurance Match Program, as well as our factual and legal understanding of the underlying workers' compensation claims, sets us apart when negotiating and disputing H.I.M.P. reimbursement requests on behalf of our clients. We handle all aspects of H.I.M.P. claims, from negotiation to formal response to the H.I.M.P.-1, and arbitration.
A Holistic Approach to Case Settlement
Our services are crafted to navigate the complexities of case settlements, including: