MSA 2nd Opinions

MSA too high? Get an MSA 2nd Opinion from Tower

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Medicare Set Asides (MSA) can get in the way of claim settlements and closures. Learn how Tower’s MSA 2nd Opinions can resolve problems and save you money!

The Problem: MSAs Can Prevent Settlements and Claim Closures

  • The MSA is too high
  • The attorney or injured party considers it too low
  • CMS issued a counter-higher

The Solution: Turn to Tower for our MSA 2nd Opinions

Our MSP Automation Suite is always up to date to capture:

  • State-specific FS overlaid with WCMSA Reference Guide
  • What is and is not covered under Medicare
  • Pharmacy price changes, e.g., Lyrica’s generic, Meloxicam price change

We measure everything, analyzing CMS responses line by line. So, we know:

  • What CMS will – and won’t – accept
  • Where to find cost drivers and discrepancies
  • When to push for a more favorable response
  • Which interventions to apply at the right time to reduce costs.
  • How to explain and document treatment changes so CMS can approve

Here are just a few of the issues we’ve found in when reviewing Medicare 2nd Opinions:

  • UDS test frequency and coding issues
  • Never filled or discontinued drugs
  • Brand drugs never changed to generics or drugs changed, but prices didn’t
  • Treatment for non-covered body parts
  • Allocations for future surgeries/procedures that may never happen
  • Lag time in price changes, e.g., lower price of Meloxicam not reflected in MSA
  • Use of inaccurate CPT codes and number of physician visits/year

If you have claims that just won’t close or received an MSA that seems unreasonably high or low, get a free MSA 2nd opinion from Tower.

Contact us at 888.331.4941 or info@TowerMSA.com and get started today.

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Getting Real Value Out of Your MSA

Case Study: 2nd Opinion MSA Review Yields $98,120 in Savings

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