Unrelated Medical Expenses Part 2

Challenging Unrelated Medical Expenses on Medicare Liens Part 2

Before you celebrate that settlement, be sure that you have considered Medicare by meeting Medicare compliance requirements. The Medicare program will aggressively pursue a personal injury lien against your plaintiff. If your client is a Medicare beneficiary, it is imperative that these benefits are accounted for and reimbursed to the appropriate program to avoid serious penalties. We encourage you to read part one of our article to learn more.

Dispute the Expenses

If after auditing the Conditional Payment Letter, you find discrepancies, circle them and submit a dispute letter to the MSPRC to have them removed. The MSPRC will review your dispute and send a new Conditional Payment Letter to you in approximately 45 to 65 days. If the MSPRC is an agreement with any of the items disputed, a lower lien amount will reflect this.

Maintaining Compliance

Handling personal injury cases requires due diligence on the part of attorneys. By law, your client must pay Medicare back from their settlement. To avoid exposure to legal damages, it is essential that you establish a process to identify Medicare beneficiaries to ensure both you and your clients meet Medicare compliance. You will need to be prepared to handle the issues that may arise in these types of cases in order to secure your client’s settlement and to avoid personal liability yourself.

Let Our Experts Help You

Medicare liens can be complex and a challenge. It is crucial that you maintain Medicare compliance to avoid serious penalties. Do not wait to partner with a settlement planner because Medicare liens take time to resolve. Additionally, you want to give yourself time to audit your client’s lien report to have all unrelated expenses removed. This will play a key role in preserving as much of your client’s settlement as possible.

Synergy Settlement Solutions has extensive experience navigating the Medicare lien process. The lien process takes some time and will require you to request updates as well as challenge new unrelated items as they appear. We know that every settlement dollar matters, therefore, we are dedicated to assisting you and your clients with the lien recovery process to protect your client’s settlement money and future benefits.

For more information or to schedule a consultation, please submit our contact request form or call (877) 242-0022.

Disclaimer: The information contained in this article is for general educational information only. This information does not constitute legal advice, is not intended to constitute legal advice, nor should it be relied upon as legal advice for your specific factual pattern or situation.

TESTIMONIALS

"In my twenty-two year career as a trial lawyer I've handled my share of catastrophic cases and structures, but imagine the complexity of an engaged, unwed mother catastrophically injured during delivery, giving birth to a healthy child, but left in a vegetative state? The issues of guardianship and entitlements of the newborn, the rights of the biological father-fiancé, an out-of-state teenage child of the mother, lifetime maintenance of the mother, as well as the rights of family of the mother, who became her primary care-takers? Synergy systematically managed the seven figure tender of one defendant, the establishment of a Qualified Settlement Fund, a Special Needs Trust, and multiple structures, all the while concurrently maintaining the various entitlements to ancillary services, as well as the remaining litigation. Everything was handled professionally, timely and literally without a hitch. Truly an amazing feat."

Marcus J. Michles II
Michles & Booth

I wanted to pass my highest recommendation to Synergy who we routinely get involved in cases when Medicare issues come up, especially when dealing with Medicare Set Asides. Synergy went beyond the call of duty in a recent case that was settled and dealt one-on-one with our clients and their family. They spent time on the phone with them to be sure they got all their questions answered and did a fantastic job dealing with Medicare.

J. Daniel Clark
Clark Martino, P.A.

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