Essential for Liability Carriers
The Medicare Secondary Payer Statute requires liability carriers to “take Medicare’s interests into consideration” when settling claims, yet does not clearly define how to do so. Demonstrating this to Medicare is no easy task and has significant financial risks if done improperly. Procuring Administration services for Medicare-allowable funds clearly shows you are considering Medicare’s interests and are not shifting a financial burden to them.
Professional Administration
Rising’s management of MSA settlement funds fully adheres to the numerous standards established by the Centers for Medicare and Medicaid Services (CMS).
We fulfill your administration needs by:
• Setting-up an MSA custodial bank account
• Determining injury-related charges
• Repricing Medicare-allowable billings per state and CMS guidelines
• Utilizing provider negotiations when necessary
• Extending pharmacy discounts and home delivery options
• Disbursing appropriate provider payments
• Submitting required reports on account activity to CMS
• Ensuring post-settlement compliance and risk mitigation for settlement parties
• Handling medical settlement funds that fall outside CMS requirements
Self-Administration Support
Not all cases need or require a professional’s management, but they call for trusted support.
That’s where we step in:
• Furnishing the injured party with necessary resources, forms and guidance to manage their MSA funds pursuant to CMS requirements
• Providing online tools, through our Patient Web Portal, that make managing MSA funds easier than paper-based administration
• Enlisting automated bill review services to reduce medical charges
• Extending pharmacy discounts and home delivery options
• Offering telephone support
• Helping safeguard payers, attorneys, structured settlement brokers and injured parties from potential negative actions by CMS