Itb s no secret. Your injured client deserves better. A whole lot better than the crummy hand they were dealt when they were injured and that then brought them to your door. B A better quality of life, one that will take care of all their needsb &and then some. Creating an income always seems to be at the top of the list. Or perhaps this involves a van with a lift to help them get around, or improvements to their house to make it more accessible. Whatever the case, they need YOU to maximize their settlement to fund it all. This means helping your client avoid or minimize the effect of those b othersb who want to cut into their piece of the pieb &including Medicare. Rather than risk your client not having any money left when the time comes to cover the eventuality of denied future medical bills, you decide to look into a Medicare Set-Aside (MSA) arrangement. Can they avoid it without the risk of Medicare denying payment for otherwise covered services? Maybe. B But if not, how much is needed to fund it? As little as possible, and hereb s why.
Medicare is a secondary payer. As mentioned in The Truth About MSAsb &How What You Donb t Know Could Hurt You, the Stalcup memo states that a settlement, judgement, or award must be exhausted for future services before Medicare can be billed. Exact text can be found below. This is the scenario you probably donb t want for your client, as paying bills that Medicare has denied could eventually leave them with little or no settlement money.
Using a portion of your clientb s settlement to set up a voluntary MSA could limit the amount that future Medicare-allowable expenses can claim from them. The key? Thereb s no law that requires a certain amount. But once this MSA amount is exhausted, the law requires Medicare to become responsible for paying your clientb s Medicare-allowable, settlement-related expenses for the rest of their life. Thus, the less you set aside, the quicker this happens and the more settlement money your client maintains. The more your client maintains, the more their quality of life can be maximized. A simple solution, now all you need to do is find someone who believes the same and will minimize their MSA to the lowest reasonable and defensible dollar amount possible.
There are three ways to go about this, and all of them are included in the routine services provided by the Plaintiffb s MSA & LIEN SOLUTION. The first step is to submit your clientb s medical and billing records to us for a thorough audit and review. Our team of registered nurses must perform this critical step prior to creating any MSA Allocation Study. If the review B uncovers that your client has stopped treatment for the injuries or conditions that are the subject of the settlement, but their treating physician wonb t put it in writing, web ll provide a letter, backed by the authority of the governmentb s Benson memo, stating that no MSA is required. However, if it canb t be avoided and a strategically minimized MSA is still something your client wants to consider, then we move on to step two.
In this step our specially-trained RN and MSCC-credentialed nurses start preparing the MSA, removing unrelated past medical and double billings, B and then challenging unnecessary treatments in order to strategically minimize the MSA amount. Challenging unrelated past medical means getting rid of anything that doesnb t match up with the injuries or conditions that are the subject of the settlement. In other words, anything that doesnb t match the ICD-9 or ICD-10 codes associated with your clientb s case. Then, double billings are removed and unnecessary future medical treatments are documented and also removed. This process should significantly reduce the amount needed to fund your clientb s MSA, but we push it even further.
Step three involves utilizing innovative strategies web ve developed for reducing MSA funding requirements even more for eligible clients. Part of this involves, at the discretion of the plaintiff attorney, using the procurement costs expended in obtaining their settlement or verdict to further minimize the funding. Then a final strategy that is so exclusive, it will only be revealed when you and your client come work with us.
It all begins with figuring out what the right move is for you and your client. Can they avoid an MSA or not? Whatever you do, donb t make this decision alone. Sign up to receive our b 2 Ways to Avoid an MSAb article. Together, we can decide if one of these b 2 Waysb can work for your client. If an MSA canb t be avoided, web ll take you and your client through our proprietary process of minimizing their liability Medicare Set-Aside. Ultimately, web ll help you and your client create a strategically minimized Medicare Set-Aside allocation to the lowest possible, reasonable and defensible number. The end result? More settlement funds in your clientb s pocket, less hassle for you, and a quality of life thatb s maximized to the fullest extent for your client.