The Lien Resolution Group

The Lien Resolution Group process

Medicare Claim Resolution Process
1-Verification- Find out if client is receiving government benefits
2-Open case with the Centers for Medicare and Medicaid Services (CMS)
3-Request Conditional Payment Summary from Medicare (MSPRC)
4-Review Conditional Payment Summary
5-Dispute unrelated medical claims
6-Request final demand – original demand less unrelated items less procurement costs
7-Request hardship waiver, if applicable
8-Attorney and/or Lien Resolution Center receives Demand letter. Payment is required to Medicare within 60 days of receipt of Demand letter, even if a waiver has been requested.

Medicaid Claim Resolution Process
1-Verification-Find out if the client is receiving government benefits
2-Determine county office handling the case
3-Identify analyst on the case
4-Dispute unrelated medical claims (if not estate case)
5-Request final demand
6-Request hardship waiver if applicable
7-See if Ahlborn is applicable

To engage The Lien Resolution Group
to resolve Medicare/Medicaid Claims
In order for us to determine the services necessary for each individual case we will need the following information submitted:

1-Completed case intake form
2-Signed releases (CMS/SSA)
3-Copy of the Summons & Complaint
4-Copy of the Bill of Particulars
5-Copy of any correspondence with Medicare/Medicaid

If your claimant’s case has settled we will need a copy of the Settlement Statement itemizing the breakdown of the settlement and a copy of the signed Settlement Agreement & Release.

The total costs involved for us to address Medicare/Medicaid’s claims will be $1,800.00. Please process your check made payable to “The Lien Resolution Group”, and reference the name of the claimant on your check.

If you have any questions regarding Medicare/Medicaid claims please contact Brett Newman at 1-800-888-1743.

Please submit all of the requested information above to:

Brett Newman
The Lien Resolution Group
216 Congers Road, Bldg 2C
New City, New York 10956

or email to bnewman@helpwithliens.com

Retainer Agreement Additions Regarding Governmental Benefits & Liens

SPELLING-OUT THE OBVIOUS

Retainer Agreement Additions Regarding Governmental Benefits & Liens

The intensifying focus on the collection of governmental liens and the tightening-of-the-belt in relation to public assistance, has created a more complex arena for the practice of personal injury. This has been magnified by the confusion and extra post-settlement labor created by the Ahlborn decision. While you understand and know what your retainer agreement states, now more than ever, it is important to make sure your retainer agreement “spells-out the obvious” i.e. limits your representation to the personal injury claim, allows the hiring of governmental and medical lien investigators, allows the retaining of additional attorneys to handle the lien resolution, and advise regarding impact of a verdict or settlement on public assistance. The below suggestions are to assist you in reviewing your fee agreement only. Of course, local bar rule should always be consulted.

LIEN INVESTAGATION COST:

I hereby authorize FIRM to take whatever legal steps it deems appropriate under the circumstances to prosecute my claim for damages, and authorize FIRM to advance on my behalf such reasonable costs and expenses as it believes to be reasonable, including but not limited to, expenses for hiring investigators, expert witnesses and/or attorneys (including attorney/experts to assist with investigating medical/governmental reimbursement liens).

DISBURSEMENT OF PROCEEDS

I understand that prior to disbursement of settlement or verdict proceeds, third-party interest such as Medicare, Medicaid, and other medical provider liens must be investigated and satisfied. I further understand that current state and federal law may require FIRM to take steps to determine if such interest exist, even if I have not received notice from medical providers prior to verdict or settlement. I understand that resolution of governmental and/or medical liens is a separate matter that may require the retention of additional attorney(s) or attorney firms under separate retainer.

INFORMING FIRM / PUBLIC ASSISTANCE

I understand that current and future public assistance, such as Medicaid, SSI, Food Stamps, subsidized housing, etc. may be affected by a verdict or settlement. I further understand that I am obligated to keep FIRM informed of any applications for such government benefits or changes in my current eligibility. Additionally, I understand that I must keep FIRM timely informed of all bills, liens and related correspondences from any health care provider or governmental agency. I understand that FIRM does not represent me in relation to applying for, obtaining or preserving governmental benefits. I understand that I must consider the impact on my current and future governmental assistance a verdict or settlement may have, and I should explore my options regarding preservation of these benefits before receiving a verdict or settlement. Failure to explore these issues before verdict or settlement may compromise my ability to do so in the future.

ldunnfox@helpwithliens.com

800-888-1743

HIPAA Compliant Medicaid Release Forms by State

Click for Hippa Compliant Medicaid Release Forms by State

ldunnfox@helpwithliens.com

800-888-1743

Wal-Mart Paid for Medical Bills & Then Sued for Money Back

JACKSON, Mo. -- A collision with a semi-trailer truck seven years ago left 52-year-old Deborah Shank permanently brain-damaged and in a wheelchair. Her husband, Jim, and three sons found a small source of solace: a $700,000 accident settlement from the trucking company involved. After legal fees and other expenses, the remaining $417,000 was put in a special trust. It was to be used for Mrs. Shank's care.

Instead, all of it is now slated to go to Mrs. Shank's former employer, Wal-Mart Stores Inc.

click here for the whole story

ldunnfox@helpwithliens.com

800-888-1743

MSA Administration

Post-Settlement Administration is critical:

The Centers for Medicare and Medicaid Services (CMS) has adopted specific requirements regarding the administration of Medicare Set-Aside (MSA) Accounts. These requirements include proper bank account establishment, accurate reporting of Medicare-allowable medical expenses, appropriate provider disbursements, and submission to CMS of the necessary reporting on account activity. These requirements are complex and are applicable whether the account is administered by a professional or self administrated.

It is critical that the account be properly used, documented and administered. Failure to follow the CMS requirements can jeopardize future Medicare benefits and create liability for industry professionals involved in the claim resolution process.

Peace of mind provided through proper administration:

Industry professionals involved in the claim resolution process and claimants can gain peace of mind by taking advantage of our expertise and knowledge. Our professional Administration services include:

Medicare Set-Aside (MSA) Account Administration

Our knowledge and expertise is focused on the preparation of the MSA custodial agreement, establishment of a MSA bank account, communication with medical providers, payment of allowable medical expenses and completion of the required accountings and reports to CMS. But most importantly, comprehensive and transparent accounting to the claimant. Additionally, our resource center can provide reversionary interest agreements if desired.

MSA Self-Administration Support Services

Not all MSA accounts require professional administration. Under appropriate circumstances, an individual can administer his/her own MSA. Our resource center can provide knowledge, forms, and the resources necessary for self-administration of a MSA account. Additionally, our professional support services are available for 1 year following account activation through our toll-free help line. Industry professionals involved in the settlement process can rest assured that due diligence has been taken in regard to these self-administered MSA accounts.

Medical Custodial Account (MCA) Administration

A MCA can be used in a variety of ways to extend and preserve all or part of medical settlement dollars. Often used in conjunction with a MSA account, professional administration can provide access to services post-settlement that would otherwise not be available on a discounted basis. These services can include case management, care coordination, discount medical equipment, and discount network and mail order pharmacy services.

ldunnfox@helpwithliens.com

800-888-1743