Medicare Set-Aside Allocation, CMS Submission & Conditional Payment Services

NuQuest/Bridge Pointe is an industry leader in Medicare Set-Aside (MSA) Allocation Services. Our specialized team of registered nurses and claims adjusters work in tandem to ensure our MSA allocation services meet the requirements of The Centers for Medicare and Medicaid Services (CMS).

All Services are available for Workers' Compensation & Liability Claims

MSA Allocation Services

MSA I
Includes MSA allocation, Social Security and Medicare status determination, Reporting to COBC to initiate Medicare conditional payment claim identification process, determination of rated age life expectancy, and recommendations for frequency and amounts of periodic payments when a structured settlement is being utilized.

MSA II
Includes all aspects of a MSA I above, plus detailed projection of non-Medicare allowable costs over the life expectancy. Costs can be calculated at WC reimbursement rates or usual and customary rates.

Non-Threshold MSA
MSA allocation for claims that do not meet the CMS threshold for review. Includes Social Security and Medicare status determination, reporting to the COBC to initiate the Medicare conditional payment claim identification process, determination of rated age life expectancy, and recommendations for frequency and amounts of periodic payments when a structured settlement is being utilized.

MCP with Free MSA

Apportions both Medicare allowable and non-Medicare allowable future injury related medical costs.  Costs are calculated at WC reimbursement rates over the rated age life expectancy.  Utilize to set reserves, obtain settlement authority or as a settlement tool now, and receive a free MSA Allocation within one year of the report completion date, if needed.

Low Dollar Settlement MSA

MSA allocation for total settlements of $25,000 or less.  Does not include Social Security and Medicare status determination, COBC reporting or conditional payment inquiry.

CMS Submission Services

Submission of MSA to CMS for Approval
Includes submission of MSA allocation and supporting documents to CMS for review and ongoing communication with CMS throughout the review process.

Submission of $0 MSA Allocation for CMS Approval
Includes preparation of submission document and supporting attachments requesting approval of a $0 MSA allocation in disputed/denied cases, Social Security and Medicare status determination, Medicare conditional payment claim identification and ongoing communication with CMS throughout the review process.

Conditional Payment Services

Medicare Conditional Payment Identification

Provides Social Security and Medicare status determination, reporting to Medicare and an estimate of Medicare conditional payments

Medicare Conditional Payment Claim Investigation
Includes a review of Medicare's claim and requests removal of any inappropriate claims

Additional Services

Rush Service
When time is critical, rush service is available for MSA allocations needed within 1-5 business days.

Social Security and Medicare Status Determination Only

Includes pursuing the required release and obtaining Social Security and Medicare benefit status, entitlement dates and eligible work quarters from the Social Security Administration

Updating a MSA Allocation
If the finalization of a settlement is delayed, interim medical records are reviewed and the MSA allocation is updated if necessary.