This case involved a Medicare beneficiary who was injured in a motor vehicle accident. The beneficiary received medical benefits via Medicare Conditional Payments of approximately $25,000. When the plaintiff’s attorney settled the personal injury action, Medicare presented a Final Demand of approximately $16,500. The plaintiff’s attorney attempted to reduce this amount via a first level appeal (Redetermination), but he was unsuccessful. At this point Synergy Lien Resolution Services was engaged.
Synergy prepared the second level appeal (Reconsideration) using our extensive knowledge of both the Medicare Secondary Payer Act and our experience in dealing with BCRC and CMS. Within 60 days Medicare had agreed with our appeal and the Final Demand was reduced to approximately $4,500.
