Compliance-driven Medical Record Review for MSAs
Ensuring Compliance-driven Medical Record Review for MSAs
Accurate and compliant medical record reviews are indispensable when preparing Medicare Set-Asides (MSAs). We understand the serious implications such as compliance issues, CMS rejections, or settlement delays of even minor documentation errors or missing details.
Our compliance-driven medical record review for MSAs ensures that every record is analyzed thoroughly, all relevant medical data is properly categorized, and the final allocation meets Medicare Secondary Payer (MSP) and CMS requirements.
With a team of medical and legal experts, we provide end-to-end support to help insurers, attorneys, and MSA vendors achieve complete regulatory confidence in every review.
Why Compliance Matters in MSA Reviews
Inaccurate or incomplete medical documentation can result in rejected Medicare set aside submissions and costly delays. A compliance-driven review ensures:
- Full adherence to Medicare and CMS guidelines
- Proper identification of injury-related vs. unrelated treatments
- Transparent justification for all future medical projections
- Reduced regulatory and financial risk
- Enhanced case defensibility and allocation accuracy
Our Approach to Compliance-driven Medical Record Review for MSAs
Record Intake and Organization
- Collect and catalog all relevant medical documents
- Identify missing or incomplete records
- Create a structured index for easy cross-referencing
Multilevel Quality Assurance
- Clinical and compliance verification by senior reviewers
- Internal audits to ensure alignment with CMS and MSP guidelines
- Final review before delivery to maintain defensibility
Prescription & Treatment Analysis
- Analyze historic and current drug use
- Project future medication costs based on treatment trends
- Identify controlled substances or overlapping prescriptions
Chronology and Summary Creation
- Prepare MSA-compliant summaries and chronologies
- Use clear timelines for easy understanding of medical progressions
- Flag assumptions or incomplete areas for client review
Detailed Medical Chart Review
- Examine physician notes, diagnostic reports, hospital records, and therapies
- Highlight injury-related treatments and eliminate unrelated ones
- Review treatment response, clinical rationale, and ongoing care plans
Documentation Standards We Follow
Our reviews are developed to meet the diligent Medicare and CMS regulations. We ensure that every MSA medical record review includes:
Benefits of MOS’ Medical Record Review Solutions
- Accurate, defensible allocations that meet CMS approval standards
- Lower compliance risks and reduced chances of case rejections
- Faster turnaround times through streamlined review workflows
- Comprehensive summaries fine-tuned to your settlement needs
- Dedicated medical-legal expertise in MSA documentation
Our goal is to help you prepare MSA submissions that are compliant, transparent, and ready for review.
Who We Serve
MOS supports a wide range of professionals and organizations involved in MSA preparation and submission:
- Attorneys and law firms handling settlement cases
- Workers’ compensation and liability insurers
- MSA vendors and allocation firms
- Third-party administrators (TPAs)
- Self-insured employers
Why Choose MOS?
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