Medicare Set Asides

Medicare Set Aside Services

Flagship Services Group specializes in Medicare Secondary Payer (MSP) Compliance services.

 

Medicare Set Asides, Flagship Services Group

Combining years of experience in the Medicare market with consistent monitoring of Medicare’s ongoing changes, we specialize in implementing processes and procedures to keep you compliant.

As a privately held company, Flagship’s priority is to offer a consultative and flexible approach in creating a unique customized program for each of our clients. We provide several innovative solutions, depending on your needs. Our goal is to form a partnership to ensure compliance while providing the highest level of customer service.

Flagship MSA services include but are not limited to the following:

  • Medical Record Analysis (MRA)
  • Pharmaceutical Analysis
  • Nurse Medical/Legal Consultations
  • Medicare Set Aside Allocations (MSA)
  • Life Care Plan (LCP)
  • Medical Cost Projection (MCP)
  • MSA Lite
  • Rush MSAs
  • Second Opinion MSA
  • CMS Submission Services
  • Rated Age
  • Professional and Self Administration of Set-Aside Allocations
  • Section 111 Reporting
  • LumenX - Section 111 Querying
  • LumenX - Easy, Accurate & Secure
  • Professional Administration Services
  • Conditional Payment Services (CP) - End to End Solutions
  • Educational Training

Flagship’s team of experts pride themselves on offering the highest quality of customer service while providing a world class experience that makes you – the customer – feel valued!


What is an MSA?

According to the Centers for Medicare and Medicaid Services (CMS) 

A Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) is a financial agreement that allocates a portion of a workers’ compensation settlement to pay for future medical services related to the workers’ compensation injury, illness, or disease. These funds must be depleted before Medicare will pay for treatment related to the workers’ compensation injury, illness, or disease.

 

All parties in a workers’ compensation case have significant responsibilities under the Medicare Secondary Payer (MSP) laws to protect Medicare’s interests when resolving cases that include future medical expenses. The recommended method to protect Medicare’s interests is a WCMSA.

 

The amount of the WCMSA is determined on a case-by-case basis.


What does the Law require?

Medicare is required by statute (42 U.S.C. § 1395y(b)) to seek reimbursement for conditional payments related to the settlement. Further, Medicare is prohibited from making payment where payment has been made (that is, where the beneficiary obtains a settlement, judgment, award, or other payment). Medicare remains the secondary payer until the settlement proceeds are appropriately exhausted.

 

42 CFR 411.46 requires that all WC settlements must adequately consider Medicare’s interests, and that, if a settlement appears to represent an attempt to shift to Medicare the responsibility for payment of medical expenses for the treatment of a work‐related condition, the settlement will not be recognized.

Do you Need an MSA? Find out Now.

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Testimonials

"Flagship has been instrumental in helping us become Medicare compliant and their expertise in lien reductions has saved us millions. They offer peace of mind, extraordinary knowledge and true professionalism that have delivered unbelievable results."

- Claim Manager

Our Mutual Insurance Company is very pleased with the Medicare compliance services provided by Flagship Services Group based on the work they have done for us over the past two years.

Flagship has been a great solution to a difficult Medicare dilemma for us!

- Casualty Claims Manager