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
In complex claims, an ECS Life Care Plan is a timely and cost-effective product to assist in settlement negotiations and provides a dynamic document for individuals who have experienced catastrophic injury or suffer chronic health needs. Based upon published standards of practice, this comprehensive assessment, data analysis and research provides an organized, concise plan for current and future medical needs along with an outline and cost of other essential services.
Legal Nurse Review
ECS legal nurse consultants review medical records and invoices delivered from opposing counsel and provide a chronological recap of events and their expenses for case preparation. Their review details inconsistent accounts of the incident and issues related to the mechanism of injury, the over utilization of services and outlines pre-existing conditions and their relatiedness to the accident.
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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