Medicare Compliance

Medicare compliance is no simple task. With more people entering the Medicare system, the Centers for Medicare and Medicaid Services (CMS) has increased efforts to protect the Medicare trust funds from depletion. As Medicare Secondary Payer (MSP) compliance rules evolve, now more than ever you need an expert partner to help you navigate the Medicare process.

What is the MSP Act?

Since 1980, the MSP Act has been the primary method for recovering money to replenish Medicare trust funds. Under the act, CMS is to be a secondary payer of workers compensation, liability, and no-fault insurance claims. If an entity bills Medicare for any medical service or products provided to a Medicare beneficiary, it must determine whether Medicare is the primary payer for those items or services.

To combat increasing fraud, shrinking funding sources, and escalating healthcare costs, through federal legislation, Medicare is cracking down on noncompliance. Medicare is imposing substantial financial penalties for non-compliance and requiring responsible parties to:

  • Report claims involving Medicare to CMS
  • Set up an MSA account to pay for future Medicare covered services
  • Reimburse Medicare for conditional payments made to healthcare providers on behalf of beneficiaries

Our Medicare Compliance Services

Synergy offers Total Medicare Compliance Services to assist attorneys and their clients. Our services include:

  • Identify/Resolution of Conditional Payments & Part C lien resolution
  • Refund Process for Conditional Payments made to Medicare
  • MSA Consultation, Funding, and Administration
  • MSA Allocation Services
  • CMS Review & Approval of Set-Aside Allocations
  • No Cost Attendance at Mediation for Client Consultation & Planning Advice
  • Settlement Documentation Consultation for MSP Compliance
  • Free Audit of Law Firm Client Files for Compliance with MSP
  • Free Firm Wide MSP Compliance Training

Why Synergy?

At Synergy Settlement Solutions, we provide our clients with a comprehensive set of services to ensure you and your clients achieve medicare compliance. We will estimate your client’s future Medicare covered services and submit the allocation to CMS for approval. We will also provide funding options, post-settlement planning recommendations, and professional administration. Whatever your client needs are regarding MSA and MSP, we are an invaluable solution for your post-settlement needs.

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

When we face difficult post resolution issues, we turn to Synergy. They provide us with the necessary expert advice about Medicare compliance, preservation of public benefits, lien resolution and settlement planning. We don’t need to go anywhere else, they are the experts when it comes to the case after the case. All of those sticky issues, they easily navigate and let us focus on other issues.

Andrew Knopf
Knopf Bigger

"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.

WordPress Image Lightbox