Claims Resolution

15 Years

Average Experience In-House Certified Life Care Planners

240 Years

Teams Total Combined Experience

How High is Your Company’s Medicare Claims Exposure?

ECS offers claims resolution services that creatively assess compliance risks and forecast pre- and post-settlement medical exposure. Our multidisciplinary team of experts address client needs from obtaining missing documentation to monitoring and evaluating exposure throughout the life of a claim. Innovative MSP professionals design comprehensive solutions focused on bringing cases to successful conclusions.

Pre-Medicare Set-Aside

The ECS Pre-Medicare Set-Aside (Pre-MSA) is a high level analysis of potential Medicare covered exposure on a claim. It assists in determining if settlement of a claim is reasonable at a given point in time and further identifies opportunities to reduce costs prior to moving forward with settlement and a full MSA.

Claims Settlement Allocation

The Claims Settlement Allocation (CSA) from ECS offers an evidence based non-submit allocation for claims that do not meet Medicare’s review thresholds, yet parties must offset future medical exposure. Our approach is aggressive and clinically based leading to allocations that fit into settlement negotiations. CSAs are particularly useful in states where an independent allocation is often required in order to finalize a settlement. 

Life Care Plan

A Life Care Plan is a dynamic document, based on published standards of practice, comprehensive assessments, and data analysis/research. The purpose is to establish and quantify medical damages from an injury, as well as take into consideration any possible item or service a claimant (evaluee) will need to maintain the highest level of independence and function throughout life expectancy.

  • The Document is used by Plaintiff and Defense to Understand Costs to Fund the Damages
  • Useful for Litigated Claims with the Potential for Jury Trial
  • Life Care Plans are used to Establish the Future Medical Value of a Claim
  • Life Care Plans can Play a Key Role in Special Needs Trusts

Medical Cost Projections

Medical Cost Projections (MCP) from ECS provide a chronological overview of the medical treatment and professional documentation for future medical needs on claim files at any time along the treatment continuum. Use of an MCP assists in identifying the probable future medical cost of a claim, which prevents stair-stepping and allows for claim reserving.

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