Workers' Compensation MSA Allocation (WCMSA):
The Centers for Medicare and Medicaid Services (CMS) claims a right of subrogation and direct right of action for injury related medical costs occurring after liability settlement. CMS further asserts the burden of future injury-related medical care should not be shifted to Medicare as a result of a settlement. A Liability Medicare Set-Aside (LMSA) prepared by a PMSAS professional provides a reasonable allocation of Medicare-covered medical expenses to be considered at the time of settlement.
Liability MSA Allocation (LMSA)
All of our allocations are prepared by registered nurses who are experienced in medical and workers' compensation case management and utilization management, and who hold the Medicare Set-Aside Certified Consultant (MSCC) credential. PMSAS utilizes medical documentation and recognized standard of care criteria in order to appropriately consider Medicare's interests and obtain CMS approval without overstating recommendations.
Condition Payment Evaluations
Our trained and experienced staff can review Conditional Payment requests from CMS and help determine which claims are actually related, and which ones should be appealed. It is better to start this process as soon as possible.