MSA Second Opinion Success Story – $46,691 in savings

June 23, 2022

This success story demonstrates how an MSA Second Opinion can lead to a successful result with settlement of a WC case.


An MSA was prepared by another MSP provider for approximately $110,000. Based on this MSA amount, the parties reached a tentative settlement. Prior to MSA submission the other MSP provider revised the MSA to $145,500 which was outside the parties settlement range. The cost drivers in the MSA were injections, surgeries and physician visits.


Tower’s MSA 2nd opinion review found the injured worker had repeatedly declined injection therapy and one of the two surgeries had not been recommended in the past two years. Consequently, Tower recommended eliminating the surgery and injections from the MSA. Our Physician Follow Up service contacted the treating physician and obtained the physician’s written statement that injections were no longer part of the treatment plan.  The physician also agreed to reduce the number of physician visits to a single annual visit.

RESULTS:  $46,691 in Savings

In addition to eliminating a surgery that fell outside the two years of medical records required by CMS, injections were removed, and physician visit frequency was reduced yielding an MSA of $98,809. The MSA report was submitted and approved by CMS and the parties were able to move forward with settlement and claim closure.

Tower’s MSA 2nd Opinion, offered at no charge, identifies, from another MSP provider’s report, discrepancies and inappropriate treatment which unnecessarily increases the MSA along with recommending interventions which may result in a lower CMS-approved MSA amount.

Tower’s Physician Follow Up Service, also offered at no charge, reaches out to the treating physician to confirm ongoing Rx and reduce excessive or unneeded treatments.

More Tower Success Stories can be found here!

MSA Optimization Yields $175,867 in Savings

June 15, 2022

stethoscope and insurance claim form


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 catheterization 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.

RESULTS: $175,867 in Savings

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.

More Tower Success Stories can be found here!

MSA 2nd Opinion Success Story – $98,120 in savings

June 7, 2022

nurse conducting research for a Medicare Set Aside Second Opinion in a manual


A Medicare Set-Aside was prepared by another MSP provider for $221,384.00.  In addition to extensive medical treatment and surgical procedures, the MSA included the medications omeprazole, ibuprofen, sertraline, and hydroxyzine.  As a settlement was not feasible with that MSA amount, it was submitted to Tower for a 2nd Opinion MSA Review.

Tower’s 2nd Opinion MSA Review is offered at no charge.


Following Tower MSA Partners’ standard MSA workflow, the Intake team compared the reported “accepted” body parts against information in the client’s claim system and determined that sertraline, intended to treat stress and depression, should be removed as “psyche/stress” was not an accepted body part. This yielded a savings of $58,320. Additionally, Tower identified inappropriate medical treatment, including an unnecessary bladder surgery, resulting in a further $37,234 reduction. Finally, Tower obtained a rated age from K.P. Underwriting, which lowered the treatment and prescription cost over life expectancy. Tower’s MSA totaled $123,263.68.

RESULTS:  $98,120 in Savings

In addition to eliminating Rx unrelated to the injury and appropriately allocating for medical treatment, Tower recommended the following pre-CMS submission to mitigate exposure and further lower the MSA:

  1. Tower drafted Body Part Letter to confirm accepted compensable conditions and specifically identified all other conditions discussed in the medical records as not “accepted” or paid for by our client.
  2. Tower’s Physician Follow Up Service, offered at no charge, to reach out to the treating physician to confirm if hydroxyzine is related to the WC injury and whether omeprazole and ibuprofen can be switched from prescription to over-the-counter versions.

More Tower Success Stories can be found here!

Download more information here or refer an MSA for a 2nd Opinion by contacting our Intake Team at 888-331-4941 or

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, or Jesse Shade,

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

March 15, 2021

People sitting around conference table discussing MSA settlements.

Tower MSA Partners knows our strengths.  And we know our business.

We’re in the Medicare Set-Aside settlement business. Everything we do, we do to make workers’ compensation settlements possible — whether they have MSAs or not. Tower has built its business processes and technology around making settlements easier, faster, smoother, and less expensive.

We recognize that the value of an MSA is its ability to facilitate workers’ compensation and liability claim settlement and closure.  We also recognize that MSAs can become stumbling blocks to injured workers and their attorneys when it comes to settling claims.  Since Tower’s goal is to break through all barriers to settlement, we formed a strategic partnership with Ametros, the leader in the professional administration of Medicare Set-Asides.

Helping Injured Workers Settle Well

Ametros, which does not produce MSAs, helps injured individuals manage their Medicare Set-Asides and medical allocations after settlement.  During the settlement process, its team educates injured workers and their attorneys on their responsibilities and the resources available to them through professional administration after the settlement. Ametros frequently attends mediations and settlement conferences to help educate all parties on the post-settlement reality of managing a Medicare Set-Aside and how its services support compliance with Medicare Secondary Payer guidelines.

CareGuard, Ametros’ professional administration service, helps injured individuals navigate the healthcare system after settlement. CareGuard Members receive significant discounts for their injury-related medical and pharmacy expenses, durable medical equipment, home health care, and other services. Ametros handles the payment of all medical bills from their settlement funds and takes care of the Medicare reporting associated with an MSA.

Once injured workers understand they can have these services after they close their claims, they’re more likely to move forward to settle the case.

Many of Tower’s clients already work with Ametros and understand the value they bring. This made the idea of working with Ametros to simplify the settlement process for clients and adjusters a natural evolution.

Taking Work Off the Adjuster’s Desk

To further boost efficiency, Tower and Ametros developed a real-time electronic data interchange (EDI) to exchange MSA, CMS, and settlement data. MSA information is automatically updated directly in Ametros’ system at the time of MSA delivery to the client, enabling the Ametros team to begin educating the injured worker, their family, and attorneys.

This is another way we take work off adjusters’ desks and accelerate settlements that involve MSAs.

Speed Settlements

Recently, Tower launched a new program with Ametros to speed settlements. Using our powerful data analytics capabilities, Tower identifies claims that meet criteria for closure and creates a settlement candidate report. Ametros is then engaged to reach out to these injured workers or their attorneys to offer professional administration as an added benefit and to gauge interest in settlements.

When settlement is indicated, Tower prepares the MSA, executes all cost-mitigation strategies and postures the claim for closure.

This is an exciting new way to proactively address claims that may have slipped out of view and generate interest in settling.  There’s no extra work for adjusters and no cost for the payer until a claim is ready to settle and an MSA is prepared.

Future posts will share other strategic partnerships that Tower has forged to build a better, stronger Tower to help you efficiently and cost effectively settle claims.

Meanwhile, have Tower create an MSA settlement candidate report for you. To learn more, contact Hany Abdelsayed (916) 878-8062.

Rita Wilson

Chief Executive Officer



Legacy Claim Settlement Initiatives 


Building a Better Tower – Cybersecurity

February 18, 2021

hands on a keyboard overlaid with a lock symbol to illustrate cybersecurity

Tower has invested in significant cybersecurity initiatives to “Build a Better Tower” for our clients.  I provided a brief overview of those initiatives in a recent article and this week I highlight Tower’s investment in protecting Tower and our clients’ data.

Tower’s Cybersecurity Defenses

Long before COVID-19 came along, bringing a tsunami of cyberattacks, Tower had already proactively strengthened our internal IT defenses.

During the fall of 2019 we partnered with Vigilant Technology Solutions to use a service that combines passive monitoring technology with certified information security analysts. Through a customized deployment of Vigilant’s NDR (Network Detection and Response) and EDR (Endpoint Detection and Response) technology, Vigilant’s analysis engines and human threat hunting has reduced the time to detect and contain threats by 99.97% over the industry average.  Without this kind of 24/7/365 monitoring and action, bad actors can enter a system undetected and stay there for months learning how to circumvent security measures and destroying backup data resources.

The graph below shows the timeline of the recent attack on SolarWinds that ultimately compromised 18,000 through deployed software.  SolarWinds CEO disclosed an updated attack timeline, indicating that hackers had first accessed SolarWinds on September 4, 2019.  SourceSolarWinds blog, January 11, 2021.

But it is not sufficient to protect our own technology. We also educated our clients and others in the industry so they could understand and prevent cyber threats. Vigilant’s CEO Chris Nyhuis joined our VP of Information Technology Jesse Shade and another expert, Rob Kolb of Premier Mindset, for an eye-opening webinar in February.  It’s available on demand. Jesse also wrote two WorkCompWire articles with excellent advice that you can read here and here.

Third-Party Risk Assessments

In addition to ensuring the protection of its internal data, Tower also implemented a Vendor Risk Assessment Process for all third parties that had access to Tower data or networks or housed servers that stored our data. Our philosophy is that we are only as strong as our weakest link.  The result of this assessment is a vendor management process that continuously measures and monitors our partners to ensure that as per the AICPA Trust Criteria, we consistently honor the commitments made to our clients.

These are just a few of the ways that Tower is continually and proactively enhancing our infrastructure, processes and offerings to deliver measurably better services to you.

Rita Wilson,
Chief Executive Officer


Building a Better Tower

February 4, 2021

Man with blocks is building a tower

To master an understatement, 2020 was an unprecedented year of uncertainty and challenge for Tower MSA Partners.

When travel came to a halt and face-to-face meetings, conferences, and other business activities transitioned to a virtual environment, a new “normal” arrived. Tower MSA Partners, like many other companies, acclimated to these changes, believing that we could wait out the pandemic. 

Very quickly though, our leadership team realized that by looking inward, this time of external change could be used as time of growth for our company.  Our introspection produced actions to further strengthen our technology and services and to identify best-in-class partners in order to provide greater value to our clients and to build a “better Tower” for all stakeholders.  

When work from home (WFH) was mandated, Tower managed the transition seamlessly.  With 24/7/365 cybersecurity protection already in place for our network and data, full business continuity was achieved.  We consistently hit our target metrics in MSA turnaround time, cost mitigation and prescription drug treatment reductions without exception.

By looking at the internal controls that protect, monitor, and drive our business, we also created a stronger Tower that included:  Tower that included:

  • Increased cybersecurity – protecting Tower’s network and its clients’ data from a cyber threat.
  • Completed an intense SOC 2 Type 1 audit
  • Pursued strategic partnerships to extend best-in-class service
  • Created and delivered valuable educational content to help clients secure their own systems and data, enhance MSP compliance, and optimize MSAs
  • Introduced a free service — a 2nd Opinion on questionable MSAs
  • Deployed a Section 111 Management Dashboard to easily identify and correct errors, avoiding the potential for monetary penalties

Over the next few weeks we’ll explain these initiatives and others designed to provide secure and cost-effective MSP compliance services for our clients.

Rita Wilson

Chief Executive Officer