Non-Submission Workers’ Compensation Medicare Set-Asides

This program offers full professional custodial services for WCMSA claims not submitted or approved by Medicare. Utilizing our Medical and Pharmacy Benefit Management resources, we guarantee cost projections that are current and realistic!

Term Date

This program offers services for the Lifetime of the claimant.

Services Include:

  • WCMSA Custodial Agreements signed by all parties
  • Annual financial statements provided to accounts showing interest earned, deposits and expenditures
  • Annual 1099-Interest forms provided to accounts for tax purposes/filing
  • Professional case management assistance
  • Utilization Review claim decisions as both injury-related and Medicare-covered
  • WC Fee Schedule adjustments
  • Medical and Pharmacy wallet-size insurance cards to assist with billing
  • Claims Payment Services
  • Bill Reviews (EOR/EOB) sent to providers along with payment
  • Pharmacy Benefit Management for cost containment and account sustainability

Pricing

Set-Up Fee (one-time only): $1000

Annual Administration Fee:
$0 (If Seed Deposit is greater than $50,000)
$500 (If Seed Deposit is less than $50,000)