Answering Questions About Medicare Set Aside Arrangements

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Without the proper consultation, workers compensation and liability claims can linger on awaiting the proper Medicare Set Aside attention. Injured workers and plaintiffs also have many questions and concerns about the Medicare Set Aside process that require proper attention.

Adjusters try to explain to insureds why their settlements are taking so long and what Medicare has to do with their claims. Attorneys try to explain to their clients why, after years of litigation, they now have to put aside money for their future treatment. At times I am recruited to speak directly to clients in Spanish about these subjects

"Every day I sit with adjusters and attorneys who are looking for effective ways to explain the concept of Medicare Set Aside Arrangements to their clients," says Gus Ortiz, President of BMA West Medical Financial Consultants, a consulting firm specializing in the Medicare Secondary Payer Act and Medicare Set Aside Arrangements. "Adjusters try to explain to insureds why their settlements are taking so long and what Medicare has to do with their claims. Attorneys try to explain to their clients why, after years of litigation, they now have to put aside money for their future treatment. At times I am recruited to speak directly to clients in Spanish about these subjects," he says.

He doesn't really mind, however, as a consultant it is part of his job. But what do you say to a claimant/plaintiff that has questions? Here are some questions that frequently pop up:

  • What is a Medicare Set Aside Arrangement (MSA)?
  • Why do I have to get a MSA?
  • What happens when the money runs out?
  • Where do I keep the money?
  • How do I spend the money?
  • What if I promise not to use Medicare for my injury treatment?

Many attorneys, defense attorneys included, have not yet mastered the Medicare Secondary payer issue and at times proceed to walk settlements through the court for approval without taking Medicare into consideration. For those who have received a recovery letter from the Centers for Medicare/ Medicaid Services seeking reimbursement on a claim previously thought to be closed; having to explain to the claimant and the insured that you have to re-open the file and deal with Medicare can be very disillusioning. It can also cause one to lose customers.

Claims professionals and attorneys would best serve their clients by ensuring that Medicare is taken into consideration anytime a claim requires settlement of future medical benefits.

BMA West Medical Financial Consultants out of southern California will be offering free Medicare Set Aside (MSA) Coaching sessions with claims professionals throughout the Pacific Coast and various other states in the West. The first sessions will take place in San Diego mid August 2008. If you would like us to visit your claims team please feel free to contact us at (949) 830-2027 in order to schedule a visit.

http://www.bmawest-msa.com

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