Synergy Blog

Lien Res Success Story – Synergy reduces Medicare Conditional Payment demand by 95% increasing the plaintiff’s “take home” by 10 fold

This case involves a dual eligible Medicare/Medicaid beneficiary who was
injured in a multiple car collision on August 1, 2012.  The elderly beneficiary suffered major injuries including a fractured femur.  Despite these serious injuries, the plaintiff was only able recover $20,000.00 from all sources.  The plaintiff’s attorney waived costs and reduced his fee so that the beneficiary would realize some portion of the nominal settlement for her injuries.  Medicare, via MSPRC, asserted a lien for the conditional payments it had advanced in the amount of $12,587.06.  Synergy was engaged to reduce the amount that the plaintiff must repay to Medicare and immediately began an aggressive lien resolution protocol.  The result of Synergy’s efforts was a Final Demand amount being issued by Medicare, via MSPRC, in the amount of $617.77.  This is a 95% savings and an increase of nearly ten times to the plaintiff’s ‘take home’.


"I just want to thank Synergy for their great work in getting a health insurance lien resolved. The health insurance company refused to reduce their lien a penny from a motorcycle accident involving my client who was not wearing a helmet, a fact that would have hurt our award in front of a jury. Synergy put tremendous pressure on this company, and after months of bombarding this insurance company with statutory requests and threats, they were able to get them to give in and reduce the lien significantly. The cost was minimal in relation to the hard work they put in, and the savings my client received. Client was very happy, and it allowed me to close out a case that I had resolved over 6 months before. Keep them in mind if you are dealing with a smug insurance adjuster who felt confident he would not have to reduce a lien, like I was dealing with. Thank you very much Synergy."

Jeffrey A. Adelman, Esq.
Adelman & Adelman, P.A.

"I recently engaged Synergy to assist with a complicated PTD settlement involving a substantial Medicare Set Aside. The claimant’s wife has been providing full time attendant care which is not Medicare covered. The Synergy nurse was able to do a full analysis of non-Medicare covered expenses which far exceeded the value of the MSA analysis performed by the carrier’s contracted MSA provider. The non- Medicare figures became the main focus of the settlement negotiations and more than doubled the value of the case. Although I could estimate the attendant care figures, the nurse added in other items that I would not have routinely considered. I also asked Synergy to evaluate the EC’s MSA as well as their prescription review. Synergy offered insight about the prescription donut hole which I did not have a clear understanding about. Again, their insight and information added a great deal of value to the overall settlement. Not only did I learn from Synergy but was able to educate my clients in the process. These are very complex and complicated areas; I will use Synergy again and again!"

Rosemary Eure
Lancaster & Eure

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