PAID Act Implementation How-to Guide Webinar, Sept. 15

August 18, 2021

Details of PAID Act Webinar with photo of Dan Anders & Jesse Shade

Join Tower’s Webinar for PAID Act implementation “How to Guide”  on September 15th.

Because of the PAID Act, self-insured employers, insurers and other non-group health plans will finally have access to Medicare Part C Advantage Plan and Part D prescription drug plan information for Medicare beneficiary claimants, starting December 11, 2021. The Centers for Medicare and Medicaid Services (CMS) will provide the data through the Section 111 reporting query process.

While the implementation of these PAID Act requirements is a technical one, it gives rise to many policy questions as to what payers are required to do once they have this data.

Join Dan Anders, Chief Compliance Officer and Jesse Shade, Chief Technology Officer on Wednesday, September 15 at 2:00 PM ET, for a webinar which will tackle both the technical and policy implications around the PAID Act.  Topics include:

  • The Part C and Part D plan identification problem the PAID Act is designed to resolve.
  • Technical changes needed to receive this new CMS data come December.
  • Best practices for handling Part C and D plan data to resolve reimbursement claims from these plans.

Dan and Jesse will describe the steps Tower has taken to ensure our Section 111 reporting clients have a seamless transition to receive the PAID Act data and how Tower can work with you to identify and resolve Part C and D plan reimbursement claims.

A Q&A session will follow the presentation.  Please click the link below and register today!

REGISTER HERE

Related Prior Posts:

PAID Act Becomes Law

Technology Drives Better Medicare Secondary Payer Compliance

August 4, 2021

People discussing technology

Build a better tower with Technology       Building a Better Tower – Through Technology

You may not think about the technology that drives Tower’s Medicare Secondary Payer compliance and Medicare Set-Aside preparation services very often – and that’s understandable.  You may like our simple user interface or the proactive communication our software generates to identify issues, make recommendations, and drive MSA optimization, or appreciate the S111 Management Dashboard, all without thinking about the technology behind the scenes.  That’s ok because we think about it everyday.  In fact, Tower’s  CEO Rita Wilson put technology front and center when she and co-founder Kristine Dudley started the company, automating much of the MSP compliance and MSA preparation operations, quality assurance, and analytics for maximum efficiency, accuracy, and productivity.

With cybersecurity in the news and hurricane season upon us, we wanted to remind you that Tower has you covered in these areas, as well.  Tower stores and manages all data, both internal and client information, securely via a cloud management partner, and has a dedicated “hot site” disaster recovery backup to ensure business continuity should our primary data center fail. For us, business continuity means Section 111 reporting, conditional payment negotiation and resolution, MSA triage, clinical interventions, final preparation, and submission all go on.

“Hurricanes do not affect Tower’s systems, data or internal processes,” Rita explained. “We have employees based all over the country, and before a hurricane impacts our Florida headquarters, our local employees have safely relocated to areas where they can continue to do their jobs with the assurance that the network, infrastructure and cybersecurity protection will be available.  If a natural disaster strikes our primary data center location, an automatic process fails over to our private hot backup site.”

Tower had mastered the IT infrastructure to support a remote workforce long before COVID-19. Aware of steadily increasing cybersecurity threat over the last several years,  the company had already secured Vigilant Technology Solutions’ services for 24/7 monitoring, intrusion detection and prevention.  With VPN access that included multi-factor authentication and secure computer and telephone systems in place, it took less than two hours for employees to transition to work from home

Tower’s complex technology is overseen by Jesse Shade, who was recently promoted to Chief Technology Officer.  This was Jesse’s third promotion in less than four years, which says a lot about how we feel his contributions and talents. Last year, Jesse designed our S111 dashboard to help clients avoid the upcoming penalties associated with erroneous or late reporting and to provide end-to-end visibility to your claims.

This year Jesse worked closely with Rita to secure our SOC 2 Type II attestation.  The SOC 2 audit is designed to give clients and prospects a level of assurance as to how a company organizes and executes its business processes and technology in a structure that provides security, privacy, and confidentiality.

It is one thing for Tower to protect our data and yours, but a major data vulnerability occurs during data transfer between Tower and its business partners.  To ensure that all data exchanged between Tower and any outside entity remains secure, we implemented a third-party risk assessment program to assess and monitor ourselves and our business partners to ensure that privacy, security and cybersecurity best practices are consistently followed.

In addition, Tower is committed to educating clients and other stakeholders.  We hosted a webinar on cybersecurity for our clients and published articles in WorkCompWire last year to help educate others in the industry.

Technology changes all the time, and Tower stays abreast of these changes, always seeking new ways to build a better Tower and a better way to serve the MSP community.  If you have questions about this article or technology in the industry, please contact Rita Wilson, Rita.Wilson@TowerMSA.com or Jesse Shade, Jesse.Shade@TowerMSA.com

Take Those Legacy Claims to Settlement!

July 13, 2021

a gavel and a magnifying glass to represent Medicare Set Aside settlement process

Tower’s Legacy Claims to Settlement Initiative identifies claims that can settle now or with intervention and produces smooth, efficient settlements.

Legacy claims. Old dog claims. Whatever you call them, these are the claims that languish on the books and just won’t close for any number of reasons.  If you missed Tower’s webinar hosted by Hany Abdelsayed, EVP of Strategic Services last month, here is a synopsis:

Legacy Claims Defined

Legacy claims can fall into one of several categories:

  • Long-term open medical claims
  • Run-off claims
  • Claims from mergers and acquisitions
  • Claims in a guaranteed cost program
  • Loss portfolio transfers
  • Non-acute cases with a high monthly medical and/or prescription drug spend

Often, legacy claims are left in the rear-view mirror as claims representatives take on new claims.  Sometimes, the injured worker or their attorney has an issue that needs to be addressed or the anticipated high cost of the Medicare Set-Aside stops the insurance carrier or employer from heading to the settlement table.  However, these legacy claims can represent significant reserves and liability for these payers that impact their entire workers’ compensation programs.

Tower’s Legacy Claims Initiatives service reviews your portfolio and identifies claims that have the potential to close, both those that that can close immediately and those that can close with intervention. We provide interventions for those that need them, customizing them to your needs and workflows.  We also identify claims that have no possibility of settling and position those for ongoing cost reduction. As the settlement project manager, Tower assembles a team with our partner professional administration Ametros and a structured settlement broker to smoothly and efficiently bring your legacy claims to closure.

We know that an MSA’s cost can pose a barrier to settlement. And we know exactly how to reduce unnecessary medical and pharmacy costs.  When scrutinizing medical records, we often find inappropriate use of opioids, muscle relaxants and benzodiazepines, often with multiple prescribers. Our free Physician Follow-up service contacts treating physicians and obtains written changes to the drug regimen. In addition, the switch of brand drugs to generics and verification of discontinued drugs and confirmation of ongoing treatment when properly documented so Medicare can approve the MSA, can result in thousands of dollars of savings on claims.

Injured workers and their attorneys can also be reluctant to settle claims.  This is where Tower’s partner Ametros, as the MSA professional administrator, can step in to talk with the injured worker and their attorney to allay any concerns they may have with closing out medical care and utilizing the MSA for future treatment.  Ametros provides medical and pharmaceutical discounts and has 24/7 care advocates available to help injured parties find providers. While injured workers often complain about the workers’ comp system, some don’t want to lose their adjusters help navigating the healthcare system, and Ametros gives them that post-settlement support.  Structured settlements help people who are afraid of spending all their money in a few years.  Tower, Ametros and the structured settlement broker also may attend mediahttps://ametros.com/tions when in-person settlements return.

When injured workers and their attorneys understand the post-settlement benefits available Ametros and structured settlement partners, they often agree to settle.

Results:

 In a settlement initiative for a large national employer, Tower and its partners were able to work with the client to settle cases with MSAs that resulted in a 43% reduction in open claims and 26% reduction in total claim costs along with a 55% reduction in CMS-approved MSA amounts compared to prior MSAs.

In a current settlement initiative started in March 2021, so far 23% of pursued claims have been settled with $60K in MSA savings because of Tower interventions.

Goal is Claim Closure

Keeping claims open is usually not the answer.  At no cost, Tower is ready to assist you as your project champion in selecting the right partners for the legacy claim settlement project and developing a plan which is customized to your type of claims and your claims team.  Further, this plan will identify and implement interventions to mitigate the MSA amount and alleviate the injured workers’ concerns in closing out their medical.

For more information or to consult on a potential legacy claims project, please contact Hany Abdelsayed at (916) 878-8062 or hany.abdelsayed@towermsa.com.

Jesse Shade has been promoted to Chief Technology Officer

June 30, 2021

Jesse Shade Portrait

With great pride, we announce Jesse Shade’s promotion to Chief Technology Officer.  As we continue to build a better tower, we recognize its foundation of technology and the people who manage it.

Technology drives Tower’s Medicare Secondary Payer and Medicare Set-Aside processes. Our technology was designed specifically for MSP compliance processes and MSA best practices with modern development tools. It takes someone with the Jesse’s experience to really understand its complexity to continually enhance, improve and maintain it.

As CTO, Jesse is responsible for the strategic planning, development, and management of Tower’s complex technologies. These include systems architecture, cybersecurity, data transfer, business continuity, and disaster recovery.

Jesse possesses an unusual blend of interpersonal and communication skills as well as technical expertise. He is a valued member of Tower’s executive leadership team, responsible for strategic planning and the education of clients and other stakeholders.

He belongs to the Forbes Technology Council, an invitation-only community of world-class CIOs, CTOs, and technology executives with track records of successfully impacting business growth metrics. A thought leader in the areas of technology and security, Jesse has presented and written on these topics, while working closely with CEO Rita Wilson to ensure that Tower has state-of-the art technology and security.

During the pandemic, he managed the work-from-home technology transition and successfully defeated countless cyberattacks. Jesse also designs and develops new products like our S111 Dashboard to help clients maintain Section 111 reporting compliance that launched along with a major upgrade to the client portal and MSP Automation Suite. Most recently, he was instrumental in helping the company successfully complete its SOC 2 Type II audit.

This is Jesse’s third promotion since joining Tower in 2017 as Director of Information Technology, bringing with him 35 years of experience in IT in the insurance, aviation, healthcare and other industries. He became Senior Vice president of Information Technology two years later. Congratulate Jesse by emailing jesse.shade@towermsa.com.

MSA Physician Follow-up Service Saves Over $200,000

June 17, 2021

Physician on Follow up call

Tower’s free Physician Follow-up service is one of our most effective tools for reducing your MSA costs. This case history offers a deeper dive on how we use this tool.

Physicians often need to try different medications as they search for the best way to manage pain, and medical records do not always show that drugs had been discontinued. That happened in a case where the initial Medicare Set-Aside exposure was $285,181.

Physician Follow-up Case Study

An injured worker suffered from low back pain along with significant pain in his groin, hip, and left knee. By the time it came to settle the case, he was seeing a pain management specialist and benefiting from oral opiates and injection therapy.

Tower’s review of his medical records detected Amrix, Celebrex, and Amitriptyline as potential unnecessary cost drivers.  We recommended having our Physician Follow-up service contact the treating physician to confirm the current drug regimen and, if appropriate, document clarifications to the medical records.

First, our Physician Follow-up professionals determined that the drug regimen for the work injury was limited to oxycodone/APAP 5/325mg BID and three injections per year and that all other medications listed in the medical records had been discontinued. Then, following the state’s jurisdictional requirements, they drafted an attestation letter stating this and obtained the doctor’s signature.

By scrutinizing the medical records and properly wording and documenting the statement, Tower submitted an MSA of $53,664 to CMS.  CMS approved the MSA within nine days with no development letter or counter-higher for a savings of $231,487.

Physician Follow-up is Comprehensive

Tower’s Physician Follow-up addresses open-ended, ambiguous and contradictory medical records and can replace a physician peer review in many cases.  With client approval and per jurisdictional requirements our team will contact the treating physician(s) to:

  • Clarify ambiguous medical treatment
  • Find out if procedures, surgeries, or other therapies are still being considered
  • Share information about multiple prescribers or pharmacies and duplicative or very similar medications
  • Discuss high doses of opioids and other addictive drugs
  • Ask the provider to consider tapering programs and alternative pain management options
  • Determine the current frequency of urine drug tests if applicable
  • Confirm the discontinuance of medications
  • Request a switch from brand drugs to generics
  • Obtain the last treatment date
  • Confirm the current injury-related drug regimen

This an area where Tower excels.  We obtain the doctor’s statement in language that is clear, concise and in a format acceptable to CMS.  Notably, 83% of the MSAs we submitted in 2020 were approved with no Development Letters.  Next time there’s an opportunity to use our Physician Follow-up service, do it.  There’s nothing to lose and a lot to save.

To see this and some of our other case studies, go to Successes, and if you need help with settling the claim right now, get in touch with Hany Abdelsayed, hany.abdelsayed@towermsa.com, (916) 878-8062.

PREMIER WEBINAR: Learn How to Take MSA Legacy Claims to Settlement

May 27, 2021

Portrait of Hany Abdelsayed with details about Legacy Claims to settlement webinar

Trying to bring more of your legacy claims to settlement? 

This could be the most valuable webinar you’ll ever attend!

Do you have aging claims that continue to draw down on indemnity and medical reserves?  Perhaps there is no ongoing medical, but the injured worker was unwilling to settle. Or maybe a claimant is willing to settle, but a prior MSA placed settlement out of reach.

These legacy claims can be settled with a program that aggressively addresses Medicare Set-Aside (MSA) cost drivers and mobilizes a settlement team that paves the way to claim closure–without increasing your adjuster’s workload.

You are invited to join Hany Abdelsayed, Tower’s expert in legacy claims settlement initiatives, for a fast-paced webinar on Thursday, June 24 at 2 p.m. Eastern.  You’ll learn about:

  • Recognizing legacy claims both obvious and hidden
  • Identifying MSA cost drivers, which impede settlement
  • Clinical interventions that contain MSA costs
  • Settlement partners who clear the path to settlement/claim closure

A Q&A session will follow the presentation.  Please click the link below and register today!

Register now

 

Dan Anders in WorkCompWire: Getting Real Value Out of Your Medicare Set Aside

May 20, 2021

a gavel and a magnifying glass to represent Medicare Set Aside settlement process

Tower believes strongly that the true business value of a Medicare Set Aside (MSA) is in its ability to facilitate the settlement of a workers’ compensation claim.  Dan Anders shared insight on this topic in this week’s WorkCompWire’s Leaders Speak column, Getting Real Value out of Your MSA.

Some WC payers see an MSA as a necessary evil when it comes to trying to settle a claim with an injured worker who is at or near Medicare age.  They have an MSA company tally the future medical and pharmacy costs and either accept the allocated cost as is or freeze in sticker shock and put off any thought of settlement.  They might even settle part of the claim and choose to keep medicals open and remain at the mercy of medical inflation.

But there’s another, better option: use the MSA as a settlement tool.  Dan’s article lays out the facts and shows you how to use an “optimized MSA” and settlement partners to settle a workers’ comp claim.

What is an Optimized Medicare Set Aside?

The word optimize means “to make as effective, perfect, or useful as possible.” For Tower, a useful MSA helps settle a claim. An effective MSA achieves the perfect balance of care, compliance and cost.

Tower reviews the claimant’s medical records carefully for cost drivers – things like brand name drugs when generics are available or discontinued medications and inappropriate or open-ended treatment.  Once these are identified, we recommend clinical interventions. With our clients’ approval, we implement these interventions.  Our Physician Follow-up service, offered at no charge when preparing an MSA, clarifies medical treatment and drug regimens with the treating physician(s), escalates the case to Physician Peer Review when needed, and obtains physician statements that document current, appropriate treatment in language CMS can use to approve the MSA.

We make MSAs as useful as possible, and we know how to build a great team of settlement partners.  Don’t settle for less.

If you have questions about settling with a CMS-approved MSA – or without one – or want to talk about any Medicare Secondary Payer compliance issue, contact Dan Anders at Daniel.anders@towermsa.com

Related Prior Posts:

Build a Better Tower: Partnerships Speed Settlements of Workers’ Comp Claims with Medicare Set Aside

Need a Second Opinion on an MSA?

Paying Tribute to Dedicated Professionals During Nurses’ Month

May 14, 2021

illustration of three nurses in scrubs for Nurses Month scrubs

According to the American Nurses Association (ANA), May is Nurses Month, dedicated to honor, thank, and support nurses and all those in the nursing profession. They’ve designated the 2021 theme as “Nurses Make a Difference.” Plus, ANA joins the World Health Organization (WHO) and global colleagues in extending the Year of the Nurse into 2021.

Tower Nurses Make a Difference

We couldn’t agree more with the sentiment that nurses make a difference, and we join in the salute.  At Tower, nurses are an integral part of our team. RNs, who hold the Medicare Set-Aside Consultant Certification (MSCC), prepare Medicare Set-Asides (MSAs).  Tower nurses review, analyze and summarize medical records and allocate care based upon Tower’s clinical standards, evidence-based medicine, and CMS MSA guidelines.

Their scrutiny often turns up gaps in care, open-ended treatment, treatment of unrelated body parts, discontinued or inappropriate prescriptions, dangerous dosages, and opportunities to switch brand drugs to generics. Once our nurses identify ways to reduce costs without compromising an injured worker’s care, specific clinical interventions are recommended to our clients.

Separate from the nurse preparing the report, a nurse-led clinical quality assurance team the accuracy of the report and makes sure all cost-containment opportunities have been considered and are presented to our client delivery of the MSA report.  Subsequently, clinical interventions, such as Tower’s Physician Follow-up service, work to obtain a physician statement and document the current, appropriate treatment in language that CMS can use to approve the MSA as written.

The difference our nurses make can be measured in Tower’s key performance indicators, which reveal a median CMS-approved MSA of $23,205. In addition, only 40% of our CMS-approved MSAs allocate for prescription medications, and 83% of them are approved without post-submission development letters. This record of success would be impossible without the dedication of our nurses.  Thank you!

Nurses Month: Stories from the pandemic frontlines

Beyond our gratitude for the nurses on our own team, for Nurses Month, we pay tribute to nurses everywhere and in every role. Nurses have been everyone’s lifeline during the pandemic but have paid a toll for the crucial role they played. We’ve compiled some stories about the experience of nurses over the past year that we found noteworthy.

What Nurses Want You to Know About the Past Year  – In this article for AARP, Michelle Crouch gathers nurses’ reactions to the past year. Nurses say that the sheer number and pace of coronavirus fatalities was overwhelming; keeping families apart was painful; mourning patients who died was painful; fear for their own and their family’s safety was a constant backdrop. They are emotionally and physically exhausted. How can we best thank and support them?

“The best way the public can support nurses right now is to get one of those vaccines, nurses say. “Please, go and get vaccinated,” Carrell-Yoder stresses. “We don’t want to do this again. We don’t want more people to die.”

All Hands On Deck”: The COVID-19 Pandemic Through Nurses’ Eyes – The Dose Podcast from Shanoor Seervai for the Commonwealth Fund looks at the experience of frontline nurses one year into the pandemic, with many experiencing stress, grief, and fatigue. Her guest is Mary Wakefield, a nurse and a professor who has held positions in the Obama administration and in the Biden-Harris transition team. When asked about lessons learned for going forward, Wakefield said:

” … our public health infrastructure, as many people recognize clearly now, is incredibly anemic. The largest proportion of public health workforce is comprised of nurses, and yet they’re still too few. We’ve seen an erosion in the United States public health infrastructure over the last number of years. That has got to be built back up. We need more public health nurses. Not the same, we need more.”

Nursing in the time of COVID-19: Two advanced practice nurses on the front lines of the pandemic – Johis Ortega and Juan M. González are advanced practice nurses and professors at the University of Miami’s School of Nursing and Health Studies. Ortega also serves as Associate Dean for Hemispheric and Global Initiatives at the school and González is Director of the Master’s Program in Family Nursing. In a story for the Pan American Health Organization (PAHO), they offer a portrait of their experience in treating patients in the peak of the pandemic.

It’s Always Been Tough Being A Nurse. Now It’s Worse – Tom Lynch of Workers Comp Insider tells us that nurses experience a shockingly high level of on-the-job injuries, including the highest rate of sprains and strains of all professions. And he says that:

“The COVID-19 pandemic has made things even worse. A new Washington Post – Kaiser Family Foundation Poll reveals roughly three out of ten health care workers are considering leaving the profession and more than half report being “burned out” due to the overwhelmingly horrific year they’ve just spent trying, and often failing, to save the lives of COVID inflicted patients.”

 

Dan Anders in WorkCompWire: Avoiding Section 111 Reporting Penalties

May 11, 2021

bullhorn illustration alerting you to avoid reporting penalties

With a name like “Mandatory Insurer Reporting” and potential reporting penalties of up to $1,000 per day per injured worker, one would think payers would take Section 111 reporting penalties pretty seriously. But since these penalties have never been enforced, avoidance of penalties has not been a top concern.

It looks like Section 111 penalties could be coming soon, though. The Centers for Medicare and Medicaid Services (CMS) positioned itself to implement them by proposing specific regulations last year. The agency solicited comments from stakeholders last April and could publish final regulations at any time.

Tower’s Chief Compliance Officer, Dan Anders, wrote an article in this week’s WorkCompWire Leaders Speak series, Plan Now to Avoid Pending Medicare Reporting Penalties, that recaps the history of Section 111 reporting and outlines reporting errors and CMS’s proposed penalties. And, unlike many articles that just tell you what CMS says, Dan’s piece recommends ways readers can steer clear of potential errors and problems.

Speaking of steering clear, if you’re not already using Tower’s S111 Management Dashboard, ask Hany Abdelsayed to take you for a test drive. Contact Hany at hany.abdelsayed@towermsa.com or 916-878-8062.

For more details on Section 111 reporting and Civil Money Penalties, check out Dan’s prior posts:

You can always contact Dan with any questions or concerns about this or any other compliance or MSA issues. He can be reached at daniel.anders@towermsa.com.

Women’s History Month: Celebrating Tower’s History as a Women-Owned Business

March 18, 2021

Portraits of Rita Wilson and Kristine Dudley. executive team of Tower, a women-owned business

As a women-owned business serving the workers’ compensation and liability insurance industry in the Medicare Set Aside (MSA) sector, we thought a great way to celebrate this month is to take a chapter from our own history. We’re pretty proud of our leadership team as well as being certified members of WBENC or the Women’s Business Enterprise National Council, a leading non-profit organization dedicated to helping women-owned businesses thrive.

Tower is not only a women-owned business, 85% of employees, including the majority of our managers and supervisors, are women.

The company was co-founded in 2011 by Rita Wilson and Kristine Wilson Dudley.

Tower Co-Founder: Rita Wilson

Rita’s path to Medicare Set-Asides wound through technology and pharmacy. She graduated summa cum laude with a BS degree from Presbyterian College in Clinton, SC, completed graduate studies at Converse College in Spartanburg, and started her tech career with a textile company.

She later became Director of Research & Development for a company that developed pharmacy management software. Her team developed standards for information exchange between group health pharmacy benefit managers (PBMs) and pharmacies. Her next move was to build out the operations and technology for a start-up workers’ comp PBM and ultimately become its CEO.

“We took insurance billing from a labor-intensive and mostly paper-bill environment into electronic adjudication,” Rita said.

In 2006, she moved to Florida and founded a diagnostic company and did some technology consulting with Speedy MSA, which was owned by Behn Wilson. He introduced Rita to his daughter, Kristie.

Tower Co-Founder: Kristine Wilson Dudley

Kristie had grown up in the workers’ comp industry and recalls going to the conference that is now WCI when she was just seven years old. Kristie went to the University of Tennessee at Chattanooga on a tennis scholarship, scoring the honor of NCAA Academic All-American in 2004.  She earned her law degree from Florida State University School of Law in Tallahassee.

She practiced law for a while, gaining workers’ comp experience with the firm of Eraclides & Gelman. While MSAs did come up, the firm saw them as necessary, but problematic. “And that’s still true with some law firms and even some adjusters today,” she said. “If you don’t do MSAs every day, they can seem like hurdles instead of opportunities to settle claims.”

While she liked practicing law, Kristie really wanted to operate a business. With Rita’s technology and pharmacy expertise, their joint understanding of MSAs, and Kristie’s legal background, the women knew they could offer deliver MSAs with a better balance of care, cost and compliance than any others in the market.

Tower MSA Facilitates Settlement

The MSA environment of the late 2000s was paper intensive, technology hungry and lacking structure, not unlike pharmacy billing before the ‘90s, according to Rita. It was hard to tell exactly what was happening at any given time with a claim and what action needed to be taken. Claims languished and collected unnecessary expenses.

“I had seen the birth of on-line pharmacy bill adjudication and the standardization of data transfer protocols and knew we could leverage technology to efficiently manage MSA production and approval processes, consistently execute workflow, drive results and accelerate settlements,” she said.

And so, these two women entered a mature market, developed a methodology that changed the paradigm as to how MSAs can facilitate settlement and created metrics to manage performance.  From the ground floor, Tower MSA Partners developed a sophisticated platform that targets cost drivers, documents recommendations of clinical and legal interventions, prompts next steps and keeps claims moving toward settlements.

Is Tower run by pushy women?

“Tower differentiates itself by aggressively seeking ways to mitigate costs and secure savings for clients,” Rita said. “Technology makes that possible.” Through claims feeds from clients, MSA specialists look for things that add unnecessary expense like possible surgeries that have not been discussed in a long time, prescriptions that were never filled, or brand drugs being used when generics could be.

“We’re different because we keep pushing.  We listen to what CMS says and we push back when we disagree with a finding, we bring evidence, we intervene.  We don’t just roll over,” Kristie insists. “Technology and measurements enable us to confidently do this.”

Is Tower run by pushy women? “We prefer ‘proactive,” Rita said, “but if the stiletto fits….”

If you’d like to connect with Rita or Kristie or Tower MSA Partners, email them at rita.wilson@towermsa.com or kristine.dudley@towermsa.com.

Related

Rita Wilson, Chief Executive Officer

Kristine M. Dudley, Esq., Chief Operations Officer