Description of Services

A. STANDARD MSA REPORT 

  • Standard Report medical claim criteria include, as an example:  stabilized herniated disks, knee injuries, multiple healed fractures or carpal tunnel syndrome
  • Review of the last 2-3 years of medical records, claim pay-out history and pharmacy record
  • Obtain rated age and life expectancy
  • Written report, which includes injury description, CPT & ICD-9 codes, summary of medical care, current and future treatment plans, Medicare and Social Security disability status, pre-existing/co-morbid conditions, and allocation amount
  • Turn Around Times with all of the necessary medical records is 2-3 weeks

B. COMPLEX MSA REPORT  

  • Complex Report claim criteria include, as an example:  catastrophic injuries including head injuries, paralysis, amputations, complex pain with morphine pumps and/or high opiate dosage, or major depression with hospitalization
  • Review of the last 2-3 years of medical records, claim pay-out history and pharmacy record
  • Obtain rated age and life expectancy
  • Written report, which includes injury description, CPT & ICD-9 codes, summary of medical care, current and future treatment plans, Medicare and Social Security disability status, pre-existing/co-morbid conditions, and allocation amount
  • Turn Around Time with all of the necessary medical records is 2-3 weeks

C. FILE SUBMISSION TO CENTERS FOR MEDICARE AND MEDICAID 

  • Compile all necessary supporting information required by CMS
  • Coordinate with all parties to the settlement
  • Request conditional payment data as appropriate
  • Submit MSA allocation as required with supportive documentation for CMS approval

D. EXPEDITED MSA REPORT

  • Two business days turnaround time
  • Additional applicable rate

E. REVISIONS, UPDATES, MEDICAL RESEARCH AND LIEN NEGOTIATIONS

  • Time and Expense

F. MEDICAL-LEGAL REVIEW TO EXPEDITE CLAIM RESOLUTION

  • File review to provide negotiating points for settlement and to provide recommendations to mitigate pending issues
  • Staffing with referral source as review develops
  • Time and Expense

G. LIFE CARE PLANNING SERVICES

  • Time and Expense

H. FUTURE MEDICAL COST PROJECTIONS (can be used in lieu of MSA for Non-Qualified Individuals who do not meet the submission criteria for Class 1 or Class 2)

  • Provides complete reserve and cost information to manage or settle claims
  • Standard Cost Projection criteria is for injuries such  as stabilized herniated disks and knee injuries, multiple healed fractures; carpal tunnel syndrome
  • Complex Cost Projection criteria is for catastrophic injuries including head injuries, paralysis, amputations, complex pain with morphine pumps and/or high opiate dosage; major depression with hospitalization

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