Medicare Set-Aside & Cost Projection Solutions

Our MSA solutions are built on the foundation of reasonable consideration of Medicare’s interest in a claim, and adequate allocation of future medical expenses and treatment needs.

We offer a variety of Medicare Set-Aside (MSA) program types and work collaboratively with our customers to address their unique settlement needs.

Our team is composed of professionals with decades of combined industry experience, which they use to guide customers through the MSA process with a focus on driving both cost and time savings.

As another option, Cost Projections can serve as a resource for settlement negotiation, assist in setting reserves, and help facilitate settlement authority. Should the case position itself for settlement, an MSA can be provided upon request.

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Medicare Set-Aside (MSA)

We work to set the standard for the way Medicare Set-Aside Arrangements (MSA) are prepared and integrated into workers’ compensation and personal injury settlements. The IMPAXX team utilizes our strong focus on customer service, long-standing industry relationships, and extensive knowledge to help facilitate successful outcomes for our customers.

Our teammates have an average of more than 15 years of experience in their respective discipline, and we have found that there simply is no substitute for relevant experience and personal commitment to our customer’s success.

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Certified MSA

An alternative to traditional MSAs, our Certified MSA utilizes evidence-based medicine, standards of care methodology, and real-world metrics to calculate future medical expenses. The Certified MSA bypasses the voluntary Medicare review process, is compliant with MSP statutes, and typically results in a reduced MSA amount providing the additional savings associated with a closed file.

In addition, our Certified MSA methodology allows for a more streamlined, efficient process and offers savings, speed, and satisfaction – helping you resolve claims faster while reducing costs and facilitating the peace of mind that comes from knowing that Medicare’s interests have been considered.

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Non-Submit MSA

Guided by evidence-based medicine and aligned with physicians’ recommendations, this type of MSA strives to avoid the costs and overfunding that can sometimes be associated with the practice of forecasting medical needs based solely on outcomes predicted during CMS review.

Non-Threshold MSA

Our experienced professionals use standards of care methodology when completing the Non-Threshold MSA for claims that do not meet the CMS review threshold.

This allocation includes a Rate Age and recommendations for future medical treatment and medications and may include annuity recommendations (upon request).

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Liability MSA

This type of MSA outlines future Medicare-covered medical treatment and prescription drug costs that would otherwise be paid by Medicare and includes a summary of current treatment and future care recommendations. Our team assists the settling parties with incorporating this information into the settlement process.

Our professionals use a Rated Age and consider standards of care and current CMS guidelines to provide adequate protection of the Medicare Trust Fund and compliance with the MSP statutes.

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Medical Cost Projection (MCP)

Medical Cost Projections provide a comprehensive review and analysis of all future medical costs associated with a case resulting in a multi-page report outlining history of injury and projected future costs in a most probable outcome approach.

 

MCPs for negotiation purposes provide a cost projection that apportions both Medicare allowable and Non-Medicare allowable future injury-related medical costs.

MCPs for reserving purposes provide all medical costs associated with the injury per recommendations in the medical records.

Surgical Cost Projections provide an estimate of the costs of a future surgery and include costs for pre-operative work up, surgeon’s fees, anesthesiologist’s fees, hospital charges, and post-operative care.

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"So far, you’ve been able to take what is normally an arduous task of getting an MSA and make it as easy and quick as possible. Thank you to you and your team!"

Sr. Claims Specialist

"You guys are always being the best! I cannot ask for a better MSA vendor! Truly amazing staff! Keep up the good work!"

Founder & President, TPA

“The best MSA presentation we have ever been given.”

CFO

"I was really at a loss for how to answer his questions! You totally saved the day."

Senior Claims Examiner

“I just have to say you guys are great to work with! I appreciate all your help!”

Structured Settlement Consultant

“I was very impressed with your company’s service yesterday. You all go the extra mile, and as a result, have a new loyal customer for life.”

Attorney

“The best firm I have ever worked with. Head and shoulders above the competition.”

Claims Supervisor

"Thank you for adjusting your schedules to accommodate. Have I mentioned that you all are the best?"

Medicare Set-Aside Specialist

“I’ve really enjoyed working with your company and have made positive comments to others within my company who will be using your services.”

Claims Professional

Thank you so much for speaking to us today and educating us on the many options you have to offer. Every claim I have is a different situation and not one is ever the same. You are awesome and do a great job keeping me straight!

Claims Handler

“I would like to send this email as an appreciation and recognition to the professionalism and excellent customer service that you provide. It is always a pleasure doing business with you. So thank you very much!”

Workers' Compensation Insurance Tech

“I am extremely grateful and impressed with the level of customer care and assistance that your company provides.“

Claims Adjuster

“Wanted to let you know what a great job your company is doing with the MSA preparations and submissions.”

Claims Professional

“Thanks so much, and great job on getting it turned around so fast!”

Claims Adjuster

“...I have worked with your team on different cases over the last six years. They are professional, responsive and always willing to help resolve matters. They make my job less stressful.”

Attorney

“I just had to say how great your staff is. They are so helpful.”

Senior Resolution Manager

“I can’t tell you how much I appreciate you and your team! You guys have been so supportive of me and in my situation that means A LOT!”

Medical Case Manager, MSA Specialist

“Everyone is great and gets right back to me. I really appreciate it. Thank you again!”

Senior Workers’ Compensation Adjuster

“This result is so incredibly amazing, and unexpected. Thank you so much for your expertise and assistance.”

Senior Claims Adjuster

“Your team is the preferred vendor in this office – they are approachable, cooperative, and work well with us. They have been successful in getting conditional payments reduced to zero dollars. Our adjusters are so comfortable, they don’t want to “try” another vendor because you have been so successful for our office.”

Claims Manager

“Responsive, easy to work with. Your portal is very user friendly, allows us to upload meds, check status, etc. You are the clear vendor of choice.”

Claims Manager

“I have had only positive results with you. The referral process is simple. Your responses for notification and completion are always timely.”

Claims Manager

"We are so grateful for your help closing a million-dollar claim. It was a very tough case and IMPAXX made it so easy."

Claims Examiner

"Everyone at IMPAXX works so hard for us."

Claims Manager