New Service - MSA Self-Administration Consultation
Through our affiliate, Protocols, LLC, our firm recently began providing MSA consultation services to claimants who self-administer their MSA accounts. The service benefits both workers' compensation insurance carriers and claimants by helping claimants find their own way through the Medicare morass while providing an alternative to expensive administration fees. Our service provides claimants with information regarding Medicare Set-Aside administration, CMS requirements, and determination of Medicare coverage for the claimant's workers' compensation injury based upon the settlement.
Click here for a full description of our MSA self-administration consultation.
If you wish to sign up for our service, please return a completed submission form to our firm:
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Self-Administration Consult Form (MS Word version, to enter data by typing)
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Self-Administration Consult Form (PDF version, to enter data by hand)
As always, please feel free to contact our firm with any questions!
Frequently Asked Questions
Q: What kind of medical records must I submit for an MSA opinion, and how many records?
A: To receive a thorough analysis, please submit all available medical records from the date of injury to the present. We realize that some cases may contain extensive amounts of records. Please contact our firm before sending a case with 12" or more of records, so we can prioritize accordingly and ensure timely processing of your case.
Q: How much information should the payment history contain?
A: The payment history should include treatment since the date of injury to the present, and each entry should show:
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Provider Name;
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Dates of Service (From and To);
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Amount Paid;
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CPT or Procedure Code;
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Insurance Company's Internal Code.
Additionally, a Microsoft Excel version of the payment history will expedite our analysis and ensure accuracy. When submitting a case, please e-mail an Excel version to msa@shdcolorado.com if available. When we receive hard copies, we must manually enter the data into our database, which introduces potential for short delays.
Do you have a question about the Medicare Set-Aside process? Submit it to eddie@shdcolorado.com for a prompt answer!
MSA Approval Update
The average time from submission of our Medicare Set-Aside proposals until CMS approvals received last month approached 29 weeks. This timeframe shows slight improvement over the past six months, which averaged 31.79 weeks. Although CMS claims to conclude its review within 45 to 60 days, our statistics show that their process takes significantly longer. However, the decreasing trend provides encouragement that CMS' review may require less time to conclude.
Please note, approval of our proposals may require slightly more time than our competitors' proposals because we advocate for the lowest MSA amount that CMS is willing to accept.
CMS Answers Additional FAQs
CMS released answers to fifteen frequently asked questions on July 11, 2005. The fifth memorandum on WCMSA FAQs, this release answers questions about threshold review levels; avoidance of indemnity payments while waiting for CMS approval; MSA effects on Medicaid eligibility, and many other helpful topics. Click here to view CMS' complete memorandum.
Staff Spotlight - MSA Consultant
Our Staff Spotlight intends to help our clients get to know the people behind our firm. This month's spotlight focuses on Eddie Phillips, MSA Consultant. Currently attending the University of Denver to achieve his Master's degree in Data Mining, he works part-time from September through June and full-time while classes are not in session. Eddie performs a variety of tasks for our firm, including: advising clients on general MSA questions; managing cases; preparing MSA settlement opinions; preparing CMS proposals; conducting statistical analyses and various tracking projects; creating and distributing HTML newsletters; and other duties. In his spare time, Eddie enjoys exploring the outdoors, exercising, swimming, traveling, laughing, and listening to music.
In This Issue:
New Service - MSA Self-Administration Consultation
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