PROFESSIONAL ADMINISTRATION
We have entered an era where The Centers for Medicare and Medicaid Services (CMS) has unprecedented access to settlement data involving Medicare beneficiaries. It is now more important than ever to ensure Medicare’s future interests are protected in your settlements. Medicare Set-Aside (MSA) professional administration is a proven tool to assure the settling parties remain in compliance with Medicare Secondary Payer (MSP) obligations.
What Is Professional Administration?
Professional administration is the practice of using a qualified third party to oversee and manage funds for future medical expenses following a liability or workers’ compensation settlement. Medicare Set-Aside account administration can be complex to navigate. Though not required, Medicare strongly suggests the professional administration of a MSA.
Third parties like Medivest follow the required steps for all Liability Medicare Set-Aside Arrangement (LMSA) and Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) administration accounts, freeing up your time to focus on your clients and cases. We establish an interest bearing account for the settlement and provide instructions for when and how to access the funds for treatment.
Many attorneys entrust these services to Medivest for benefits like:
- Streamlined reporting and compliance. Medivest specialists handle the annual Medicare accounting report and maintain the line item detail required for MSP compliance.
- Savings on treatment, equipment and pharmaceuticals. We negotiate with suppliers for more favorable pricing, resulting in significant savings for your client.
- Expert support and service. Our team has over two decades of industry experience and provides knowledgeable advice and excellent customer service.
Medivest is the leading Medicare Set-Aside (MSA) professional administration provider in the industry. We were the first to professionally administer a Medicare Set-Aside Arrangement, and have been providing this service to the workers’ compensation and liability industry for over 20 years, longer than anyone else. Our services guarantee the most comprehensive and cost-effective professional administration program available. You can be confident that you’re working with the most experienced and trained MSA professionals in the field. The result is unparalleled competency, capability, and service.
Medivest was the first company to professionally administer a Medicare Set-Aside Arrangement. We have been providing professional administration services for over 25 years – longer than anyone else in the industry. No one is more experienced.
Unparalleled Fiduciary Expertise
The Complex Made Simple for the Injured Person
Medivest makes utilizing the custodial account easy.
1. The injured person shows their Medivest Member ID Card to their doctor when they seek treatment, or to their pharmacist when they fill their prescriptions.
2. Their doctor or pharmacist will contact Medivest to verify benefits, just as they would with any other major medical insurance provider.
3. The injured party’s billing notices are then sent directly to Medivest for processing.
No co-pays, deductibles or out-of-pocket expenses when you visit your doctor or fill a prescription.
As Comprehensive as You Need It
You may not be aware that Medivest can administer more than just the Medicare allowable portion of a settlement. In addition to the Medicare set-aside, the non-Medicare allowable funds can also be professionally administered. This can represent a huge benefit and convenience to the injured person.
Medicare Set-Aside Account
Medicare Set-Aside Professional Administration strictly pertains to the management of the Medicare Set-Aside funds only. This service involves adjudication and approval of only Medicare allowable expenses related to the injury. All expenses are paid at the appropriate fee schedule. This is the most comprehensive Medicare Secondary Payer compliance measure available today.
Medical Custodial Account
Medical Custodial Professional Administration pertains to the management of a medical custodial account that typically consists of any non-Medicare allowable medical expenses. This service involves adjudication and approval of expenses as dictated by the settlement. MCAs can be used to address a wide variety of issues, from paying only non-Medicare allowable medical expenses, to paying copays on insurance premiums, Medicare copays if the MSA temporarily or permanently exhausts, and even other expenses such as living expenses.
Periodic distributions can also be made to the injured person, as dictated by the settlement. The flexibility of the MCA makes it a useful tool that protects settlement funds from dissipation risk. It offers the settling parties assurance that these funds will be used in accordance with the intent of the settlement.
Advantages to Having Both Accounts Administered Together
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Flexible arrangements can be made that can take special circumstances into consideration without jeopardizing MSP compliance.
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Both the Medicare allowable and non-Medicare allowable portions of the claim can be paid, instead of the injured person being responsible for either portion themselves.
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Coordination with CMS during MSA exhaustions to pay Medicare copays, resulting in no out-of-pocket medical expenses for the injured person.
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Deep discounts on annual fees when both accounts are administered by Medivest as a bundle.
Integrating Medivest Medicare Set-Aside Professional Administration Services Into Your Settlement
We’ve helped settling parties engineer win-win solutions in every state in this nation. From simple straightforward claims, to the most complex, we’ve developed resolutions that address an array of post-settlement concerns. Medivest’s settlement consultants provide the necessary agreements, settlement language, and guidance to considerably simplify the integration of medicare set-aside professional administration into a settlement. Services such as file review, mediation consultation, on-site training, and waiver language are provided free of charge, regardless of whether medicare set-aside professional administration is utilized. We’re committed to facilitating solutions.
Other Services from Medivest
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