MSA Fee Form

  • I agree that this non-refundable advance fee is reasonable and equitable based on the initial work associated with intake, verification, evaluation, and mandatory reporting involved in lien resolution. In addition, I agree to pay the remaining balance of the fee for Medicare Secondary Payer/Medicare Set Aside services upon receipt of an invoice from Synergy Settlement Services. I, individually and on behalf of my law firm, hereby release and agree to hold Synergy Settlement Services, its employees, officers, directors, agents and affiliates harmless from any costs, expenses, penalties, fees, damages and other liabilities resulting from, arising out of, or in connection with any claims, actions, agency actions or other judicial or administrative actions relating to Medicare Secondary Payer / Medicare Set Aside Services if such action is predicated upon inaccurate or incorrect information provided to Synergy in relation to lien resolution functions requested by me or my law firm.

TESTIMONIALS

"Coincidentally, on the day of a recent Synergy Seminar on Medicare & ERISA lien resolution I received a letter on an ERISA lien. This letter followed much back and forth between myself and the recovery vendor for BCBS. Despite my efforts they were adamant there would be no (zero)(zilch)(nada) reduction and provided case law to support their position. I tried Synergy’s Lien Resolution Services since I had just heard their Director of Lien Resolution speak. Synergy got them to reduce their claim by a third in less than ten (10) days. The result was quick and the fee very reasonable. If you have a tough ERISA lien and your typical efforts don’t work, give Synergy a try."

Michael S. Smith, Esq.
Lesser, Lesser, Landy & Smith, PLLC

"I just wanted to say thanks to you and the entire Synergy Settlement Services team for helping us put together a series of structured settlements and special needs trusts in two complex cases involving significant recoveries. As always, your accessibility, guidance and expertise on a whole host of post-settlement issues is very much appreciated and valued, particularly with respect to the often confusing topic of Medicare set asides. I look forward to our continued collaboration on cases in the future and am very appreciate of the first rate service your company continues to provide to our clients."

Stephan Le Clainche
Formerly of Babbitt, Johnson, Osborne & Le Clainche

Premier Clients

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The Synergy Settlements team will work diligently to ensure your case gets the attention it deserves. Contact one of our legal experts and get a professional review of your case today.

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