Conditional payments are payments that Medicare makes on behalf of a Medicare recipient for medical services that may be subject to reimbursement by another responsible party. We identify the existence of a conditional payment lien and analyze the merits of each component of the lien. We apply cost-reduction strategies to prevent over-payment on behalf of our clients and to insure that what is paid is what is rightfully owed. Our medical and legal professionals take a two-tiered approach to negotiation with Medicare:
Identify any medical payments included in the proposed lien amount that are not related to the case or claim.
Identify any legal reasons that Medicare may not be entitled to collect the full-proposed lien amount.
Using appropriate argument and identifying the medical payments which are unrelated to the case allows for increased potential savings to the client. In cases involving third party liability, no fault insurance or worker’s compensation liability, proper negotiation and resolution of CMS conditional payments by our certified experts will help you settle claims and avoid CMS fines, interest and double damages for unpaid liens and unapproved settlements.
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We specialize in complex and catastrophic medical claim reviews for the purposes of developing case closure, settlement strategies and developing future medical care required as well as projecting the value of that care. We assist with obtaining experts and attend mediations, medical depositions and trials.