Reliance on Tower’s extensive experience with Medicare conditional payments, state Medicaid liens and Medicare Advantage plan reimbursement ensures our clients do not pay a dollar more than necessary to resolve a lien.
Tower is your one-stop shop for complete Medicare conditional payment resolution. Our specialists investigate and, when necessary, dispute or appeal your Medicare conditional payment letters, notices and demands. Seventy percent of our conditional payment appeals result in $0 owed to Medicare. And when $0 owed cannot be achieved, average reductions are typically 90% or more. Our goal is the same as yours: a smooth settlement unhindered by conditional payment issues.
Almost half of Medicare beneficiaries are enrolled in Part C Medicare Advantage plans rather than Original Medicare (Parts A and B). Tower reaches out to the MA plan to request any claims for reimbursement, which we scrutinize and dispute when appropriate. We will facilitate the resolution of the MA plan’s interest at the time of settlement.
State Medicaid plans are increasingly asserting their lien rights. When a claimant is identified as a Medicaid recipient Tower can contact Medicaid to identify whether a lien will be asserted and, when necessary, negotiate the lien as part of claim settlement.
While Medicare conditional payment matters can be handled case-by-case, we strongly recommend a complete integration approach. By complete integration, we mean naming Tower as your recovery agent with the CMS Commercial Repayment Center. This way, Tower receives copies of all your CRC correspondence, and we can diary these, alert you to impending deadlines and take immediate action to protect your interest.
As a first step to determine the potential for Medicare conditional payments or the necessity of an MSA, Tower can conduct a quick Medicare beneficiary check. We can also submit a request to Social Security to verify entitlement status.