Medicare Set Aside Medical Summary with Cost Projection
(Workers Compensation)
Medicare has ruled that it will only be a secondary payer to worker's compensation files and will not be responsible for payment of medical issues related to workers compensation injuries. The Medicare Set Aside is prepared initially by identifying any leins on the proposed file, completing a projected cost analysis for future medicals and the submission of the file to Medicare for evaluation of acceptance.
Identifies medical issues and strategies to minimize exposure or position the file for closure. This estimates the medical costs for both non-catastrophic and catastrophic files, including Spinal Cord Injuries, Acute Brain Injuries, burns, complex cases such as multiple injuries, RSD, Amputations
All worker's compensation cases, and liability cases ready for settlement must be reviewed internally to determine if a medicare set aside is required prior to completion of the settlement. If the case meets a two prong criteria, then these cases must have a Medicare Set Aside plan developed. Call us for information concerning how to ensure that your file meets and satisfies the medicare rulings.
Other uses for cost projections:
A recent supreme court case ruled that Medicade has to have a cost projection for future care on all cases that are involved in a third party suit. They are only able to redeem funds that were deemed appropriate prior to the trial.
Specific episodes of needs such as the cost of a surgery, yearly maintenance for specific problems, costs of equipment etc.