Allocation Report: A report following the format mandated by CMS that identifies Medicare covered services and costs that are projected to continue following a settlement of the claim;
CMS Submission: All documents as outlined by CMS are compiled and submitted for CMS approval of the amount of money projected as needed to satisfy Medicare’s interest.
Reporting
Effective July of 2009, all injury claims with a Medicare element are to be reported as early into the claim as this information is determined. PRO MED provides this reporting service.
Lien Search / Review / Negotiations
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Medicare may make inadvertent payments for treatment as a result of injury. Prior to settling an injury claim, it is required that this information be determined and that Medicare be reimbursed before the claim can be considered completely closed. PRO MED provides the contact to Medicare to obtain a report of any payments made.
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When Medicare identifies what they feel is treatment that was inappropriately paid by them, they provide this document and request payment. PRO MED reviews the document to determine if all looks like it is related to the claim and if not, will negotiate with Medicare to reduce the amount.
The Official U.S. Government Site for People with Medicare
Centers for Medicare and Medicaid Services
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