This case involved a Medicare beneficiary who was injured as a result of medical malpractice. When the plaintiff’s attorney settled the personal injury action, Medicare presented a Final Demand of approximately $36,400. The plaintiff’s attorney paid the Final Demand to avoid interest and then attempted to reduce this amount via a first level appeal (Redetermination) but was unsuccessful.
Synergy Lien Resolution Services was engaged, and we prepared the second level appeal (Reconsideration) using our intimate knowledge of both the Medicare Secondary Payer Act, and our unrivaled experience with the Medicare appeals process. Maximus, Medicare’s Appeals contractor, agreed with Synergy, removed all claims and issued a refund to the beneficiary in the amount $36,400.