Medicare Set-Aside
Seamless Process. Accurate Allocations.
Through our Medicare Set-Aside (MSA) and life care planning programs (LCP), Procura is committed to maintaining an equal balance of protection for both the Centers for Medicare and Medicaid Services (CMS) and the payer. Our comprehensive program ensures pharmacy and ancillary healthcare services are appropriately allocated as specified by CMS under the Medicare Secondary Payer (MSP) statute.
Procura’s program utilizes in-depth pharmacy and ancillary healthcare services knowledge provided by expert MSA specialists. Through an interdisciplinary team, Procura ensures the most accurate and lowest defendable allocation amount available.
Our Medicare Set-Aside management program includes:
- Report Compilation and Submission According to CMS Guidelines. Each allocation report is customized to individual claim needs. Quality assurance is performed by MSA consultants. When the MSA package is submitted to CMS, Procura’s team of experts follow through with the regional CMS office until acceptance.
- Dedicated Account Specialists. Procura provides a team of dedicated account specialists to ensure that each customer’s pre-settlement needs are met and the allocation process is seamlessly managed.
- Internal Pharmacy and Ancillary Healthcare Services Expertise. Procura has a proven track record of managing pharmacy and ancillary healthcare services though our nationwide network of pharmacy and specialty services providers. We leverage this expertise in the preparation of each MSA.
- Clinical Rx™ Retrospective Drug Review Program. Pharmacists review a claimant’s prescription history to provide an expert opinion of the claimant’s medication regimen to confirm that medications are appropriate and compensable to the injury.
Through internal databases, Procura has access to the most current Usual and Customary Medicare allowable pricing. Our software provides a secure web-based view into the status of each allocation report at any time. Completed reports can be quickly printed for further review. Our experts help to provide the support and education adjusters need to efficiently manage the pre-settlement allocation process.
Procura ensures timely turnaround for MSA and LCP allocation report completion. With our proven approval rating, Procura is an MSA partner you can trust.
Contact a Procura representative to learn more about our Medicare Set-Aside and Life Care Planning Services.
