Medicare Set-Aside

Determine appropriate set-aside amounts and secure Medicare approval

Workers' compensation payers are under increasing pressure to consider and protect the interests of Medicare when settling claims. In fact, under federal law, any entity found to be shifting the burden to Medicare to pay for future medical costs related to an injured individual's workers' compensation/liability/automobile injury, accident, or illness can be held liable for double damages, penalties, and fines.

To protect Medicare interests, an appropriate amount of settlement money should be "set-aside" for the payment of future medical costs that might otherwise be paid by Medicare. Genex’s Medicare Set-Aside (MSA) program assists in meeting these obligations.

This Solution Helps Mitigate

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Regulatory Changes & Fines

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Lost Time & Productivity

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Control Medical Costs

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Adjuster Overload

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Siloed Data
Reduce Medical Expenses

Planning for the future

Life Care Planning allows adjusters and attorneys working with disabled individuals to plan for the future with the knowledge of when and how the expenditures for care will be allocated, allowing for financial planning and the setting of reserves from provider sources. Life Care Plans also provide an excellent tool for claim settlement negotiations.

Highly-qualified professionals, with more than 25 years of experience in Life Care Planning, accurately establish and quantify medical damages resulting from an injury. We provide a detailed outline of the current and future medical, vocational, educational, and psychosocial needs of a catastrophically ill or injured individual, while projecting the related costs annually or over the individual's life expectancy.

Reduce Medical Expenses

Cost savings

Genex boasts a high level of submission accuracy, with industry-leading CMS approval rates. We also employ unique strategies to help reduce MSA allocations.

Increase Claims Processing Efficiency

Trusted expertise

We will partner with you to navigate easily and thoroughly through the complexity of the MSA process. Our customer handling achieves rapid results and reduces turnaround time.

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See how Genex reduced conditional payment by 99.6%

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Medicare Set-Aside Results

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Advantages of Genex’s Medicare Set-Aside

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Need to reduce your total cost of risk?

To help lower your total cost of risk and return injured workers to work as quickly as possible, we offer a FREE consultation with a workers’ comp expert. Together, we will begin to build a workers' comp program to meet your company’s unique needs.