MSA Fee Form

  • I agree that this non-refundable advance fee is reasonable and equitable based on the initial work associated with intake, verification, evaluation, and mandatory reporting involved in lien resolution. In addition, I agree to pay the remaining balance of the fee for Medicare Secondary Payer/Medicare Set Aside services upon receipt of an invoice from Synergy Settlement Services. I, individually and on behalf of my law firm, hereby release and agree to hold Synergy Settlement Services, its employees, officers, directors, agents and affiliates harmless from any costs, expenses, penalties, fees, damages and other liabilities resulting from, arising out of, or in connection with any claims, actions, agency actions or other judicial or administrative actions relating to Medicare Secondary Payer / Medicare Set Aside Services if such action is predicated upon inaccurate or incorrect information provided to Synergy in relation to lien resolution functions requested by me or my law firm.
  • Date Format: MM slash DD slash YYYY

Premier Clients

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TESTIMONIALS

“Synergy is our guiding light for deferring our contingent legal fees and planning for retirement. The lawyers at Panter Panter & Sampedro, myself included, have been working with them for over ten years using different methods to defer comp and plan for retirement.”

Brett Panter
Panter, Panter & Sampedro

"I don't think I've directly said "thank you" for helping us with Bridgett’s case. We sent the reduced payment to Medicaid and called Bridgett's mom to tell her approximately how much money was going to be left for Bridgett and she broke down over the telephone. Given only $25k of insurance and a $850k medical bill from the hospital she didn't think Bridgett would ever see a penny."

Tom L. Copeland
Jeffrey Meldon & Associates, P.A.

Hospital "Liens" vs. "Debts": A Distinction With a BIG Difference ​​​​​​​Third Thursday Webinar Series

Join Director of Synergy Medical Bill Clinic, Michael Walrath, Esq. as he delves into the differences between “direct provider liens” and mere “medical debts.” In this webinar, he will describe how and why these important distinctions impact the lien resolution process and expected outcomes, while also dictating the various ethical and legal exposures faced by Plaintiffs’ Lawyers, post-settlement. A 15 minute Q&A will follow the presentation.

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