Synergy Blog

Synergy’s tenacious use of MSPRC appeal process results in a vacated appeal and a refund of $1,316.25 to the beneficiary

This case involved a Medicare beneficiary who was injured in June 2010 when her  vehicle was struck violently in the rear by the third party forcing into the car in front of her.  The plaintiff incurred medical damages in excess of $6,800 for injuries to her chest and shoulder.  The plaintiff was able to recover $28,000.00 from the tortfeasor’s Bodily Injury policy and MSPRC on behalf of Medicare asserted a Final Demand in the amount of $4,862.32.  Counsel for the beneficiary engaged Synergy Lien Resolution Service to resolve the lien asserted by MSPRC as their efforts had proven fruitless.  MSPRC had included unrelated charges in their lien claim, but despite the attorney’s efforts MSPRC would not remove the charges.  In order to avoid the accumulation of interest the plaintiff paid the MSPRC Final Demand and Synergy appealed, via Redetermination.  Though MSPRC was initially prevailed  in the Redetermination and was able to keep the unrelated charges on their lien claim Synergy tenaciously continued to fight.  Synergy’s Lead Resolution Specialist requested that MSRPC vacate that ruling and re-examine the medical evidence.  Within thirty days MSPRC  agreed to:  vacate the order, reduced their demand by 27%, and began processing a refund in the amount of $1,316.25 (the full amount of unrelated charges).   

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