Our CEO's strong IT background and a corporate belief that technology must drive execution inspired Tower to develop an extremely sophisticated technology — the Tower MSP Automation Suite — to manage every aspect of our proactive business processes. The suite consolidates our more than 50 years of compliance expertise into the latest, proven technologies.
Tower's fully integrated MSP Automation Suite identifies barriers to settlement and prompts resolutions as it tracks each claim from intake to closure and provides end-to-end visibility into the claim's progress. We proactively intervene to address unnecessary medical costs and inappropriate drug usage and obtain the evidence needed for CMS approval before preparing the MSA.
We are the only company in our industry with a single point of contact through every step in the process. We remain involved until the closure of your claim and pride ourselves making the process easy for our clients. We are with you every step of the way.
Tower was engaged to prepare an MSA for a 54 year old partial quadriplegic. The lack of current medical records, the erratic behavior of the patient, the quality of the provider’s treatment coding, and unknown treatment outside of the WC Plan were challenges to preparing an accurate MSA. The preliminary MSA amount was $424,528.
In review of the treatment records, Tower’s medical experts were able to identify several instances where Medicare covered expenses could be reduced as part of Tower’s Optimized MSA process. At Tower’s request, the client obtained current medical records. Tower’s clinical team reviewed those records and the corresponding billing codes used for all treatments. By analyzing the provider’s treatment methods against Medicare’s reimbursement requirements, Tower was able to identify items that were more accurately priced with alternative codes. One instance identified was a determination that a catherization code (A4353) was used incorrectly. By using the correct billing code and applying other cost savings strategies to the treatment regimen, the MSA dollars were significantly reduced. To ensure that CMS would accept the updated medical coding, Tower detailed how the original billing code was incorrectly used and then provided the correct coding.
Upon finalization of the optimized MSA, a total allocation amount of $248,661 was submitted to CMS for review and approval. CMS accepted the proposed MSA amount and responded with a Full Approval. Using Tower’s proprietary processes and technology, the client carrier was able to reduce the Medicare exposure of this settlement resulting in total savings of $175,867.
MSA Cost Savings from Clinical Intervention
Average Conditional Payments Savings
Pre-Validation Checks
Conditional Payments Reduced to $0
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