Synergy Blog

Lien Res Success Story – Synergy’s flat fee Medicare Conditional Payment Service reduces repayment obligation by 93%

Synergy’s flat fee Medicare Conditional Payment Audit and Verification service reduces the repayment obligation for the client of one of our premier Virginia customers by over 93%.  This case was referred to Synergy by one of our long standing premier clients who fully outsources all of their Medicare Conditional Payment resolution to us.  In this case, the Medicare beneficiary was injured in a motor vehicle accident wherein he suffered minor injuries.  The plaintiff retained counsel and began prosecuting a claim against the tortfeasor.  The case eventually settled, but Medicare continued to include unrelated care in their Conditional Payment claims summary.  Synergy worked with plaintiff’s counsel, and without any unnecessary delay, was able to have the unrelated charges removed and a Final Demand issued.   The result was a savings of $7,564.11 which added 60% more to the plaintiff’s net recovery.


"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

"Synergy is an invaluable partner in the mediation process. They have extensive expertise in Medicare, Medicaid and Structured Settlements and the ability to explain the impact of these complex concepts to my clients in simple, clear and understandable language. This allows me to focus on obtaining the best possible result in the settlement process."

Michael J. Winer, Esq.
President Florida Workers Advocates (FWA)

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