It’s no secret. Your injured client deserves better. A whole lot better than a crummy hand dealt from the injuries that bring them to your door. What they deserve is a better quality of life. One that will take care of all their needs. And then some. Creating an income always seems to be at the top of the list. Or perhaps a van with a lift to help them get around. Or making their house more accessible.
Whatever the case, they need YOU to maximize their settlement to fund it. This means helping your client avoid or minimize the effect of those “others” who want to cut into their piece of the pie. Including Medicare. Do you risk your client not having any money left when the time comes to cover the eventuality of denied future medical bills? No. 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. Maybe not. But if not, how much do they need to fund it with? As little as possible. And here’s why.
The 411 on Medicare and MSAs
Medicare is a secondary payer. As mentioned here, the Stalcup memo states that a settlement, judgement, or award must be exhausted for future services before Medicare can be billed. Exact text is below. This is the scenario you don’t want for your client. Especially, as paying denied Medicare bills could leave them with little or no settlement money.
Using a portion of your client’s settlement to set up a voluntary MSA could limit the amount that future Medicare-allowable expenses can claim. The key? There’s no law that requires a certain amount. That’s right. Once your client exhausts this MSA amount, the law requires Medicare to pay your client’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 keeps. The more settlement money your client keeps, the more it can maximize their quality of life. A simple solution. Now all you need to do is find someone who believes the same. Not to mention, someone who will minimize their MSA to the lowest reasonable and defensible dollar amount possible.
There are three ways to go about this. All of them are included in the routine services provided by the PLAINTIFF’S MSA AND LIEN SOLUTION.
The First Way to Avoid an MSA
The first step is to submit your client’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 uncovers that your client no longer receives treatment for the injuries or conditions that are the subject of the settlement, but their treating physician won’t put it in writing, we’ll provide a letter. This letter, backed by the authority of the government’s Benson memo, will state that no MSA is required. However, perhaps your client can’t avoid it. Also, perhaps a strategically-minimized MSA is still something they want to consider. Then we move on to step two.
The Second Way to Avoid an MSA
In this step our specially-trained RN and MSCC-credentialed nurses start preparing the MSA. Removing unrelated past medical and double billings, and then challenging unnecessary treatments in order to strategically minimize the MSA amount. Challenging unrelated past medical means getting rid of anything that doesn’t match up with the injuries or conditions that are the subject of the settlement. In other words, anything that doesn’t match the ICD-9 or ICD-10 codes associated with your client’s case. Then, they remove double billings and document and remove unnecessary future medical treatments. This process should significantly reduce the amount needed to fund your client’s MSA. But, we push it even further.
The Third Way to Avoid an MSA
Step three involves utilizing innovative strategies we’ve developed. These strategies reduce MSA funding requirements even more. But only for eligible clients. Part of this involves, at the discretion of the plaintiff attorney, using the procurement costs. Specifically, those expended in obtaining their settlement or verdict to further minimize the funding. Then, a final strategy. One that is so exclusive. In fact, we will only reveal it when you and your client come work with us. Before that, it’s all about what the right move is for you and your client.
Let Us Help
Can they avoid an MSA? Or not? Whatever you do, don’t make this decision alone. Sign up to receive our 2 Ways to Avoid an MSA article. Together, we can decide if one of these two ways can work for your client. And if it’s not possible to avoid an MSA? Then we’ll take you and your client through our proprietary process of minimizing their Liability Medicare Set-Aside. Ultimately, we’ll help you and your client create a strategically-minimized Medicare Set-Aside allocation. How minimized? One that comes down to the lowest possible, reasonable and defensible number. The end result? More settlement funds in your client’s pocket and less hassle for you, plus a quality of life that’s maximized to the fullest extent for your client.