As a healthcare provider or medical billing professional, you may occasionally come across patients whose care is linked to a workers’ compensation or liability settlement. In these cases, Medicare requires special handling of future medical costs related to the injury or condition. This is where a Medicare Set-Aside (MSA) Account comes into play.

What is a Medicare Set-Aside (MSA) Account?

When a worker or patient has an injury settlement, a portion of the settlement funds is set aside to pay for future Medicare-covered medical care and devices related to the covered injury. The MSA account follows the Medicare Secondary Payer (MSP) statute which states Medicare should be the secondary payer for injury-related care that would typically be covered by Medicare.

With an MSA administered by Medivest, an injured person has open provider access, meaning they are not limited to a specific provider or group. They are free to visit the healthcare providers of their choice. Additionally, Medivest does not require preauthorization for treatments or services paid through an MSA.

What is Medivest’s role?

Medivest has been hired as the Professional Administrator to manage the patient’s MSA account. As an administrator, Medivest’s duties include:

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