At Denise W. Wrenn & Associates our medical cost projections provides an unbiased third party estimation of the total medical, durable medical equipment (DME) and prescription drug value of a claim.

A Medical Cost Projection is a tool for setting accurate reserves and can be a key component for settlement negotiations. It is an ideal product for claims where an MSA is not yet appropriate.

Our medical cost projection reports are based upon a comprehensive analysis of all relevant and appropriate medical reports obtained from all treating sources, payment history and prescription drug cost associated with an injury or accident.

The report provides a medical summary that includes the initial injury information, current treatment, future medical needs, and any pre-existing or co-morbid conditions.

What are Medical Cost Projections?

At Denise W. Wrenn & Associates our medical cost projections provides an unbiased third party estimation of the total medical, durable medical equipment (DME) and prescription drug value of a claim.

A Medical Cost Projection is a tool for setting accurate reserves and can be a key component for settlement negotiations. It is an ideal product for claims where an MSA is not yet appropriate.

Our medical cost projection reports are based upon a comprehensive analysis of all relevant and appropriate medical reports obtained from all treating sources, payment history and prescription drug cost associated with an injury or accident.

The report provides a medical summary that includes the initial injury information, current treatment, future medical needs, and any pre-existing or co-morbid conditions.

What are Medical Cost Projections?

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Medicare Set Aside

Our professionals provide an accurate projection of the anticipated Medicare and non-Medicare covered services related to your client’s future medical costs through the individual’s life expectancy. This cost may be associated with Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA), a Liability Insurance Medicare Set-Aside Arrangement (LMSA), or a No-Fault Insurance Medicare Set-Aside Arrangement (NFMSA).

Cost projections include a detailed description of each allocated service by Medicare, including Part D prescription and Off-Label Drug review while thoroughly determining the amount of money to “set aside” from the settlement proceeds for future medical costs.

What is a Medicare Set Aside (MSA)?

An MSA is a financial arrangement that allocates a portion of a settlement, judgment, award, or other payment to pay for future medical services. When future medical care is claimed, or settlement, judgment, award, or other payment releases (or has the effect of releasing) claims for future medical care; it can reasonably be expected that the monies from the settlement, judgment, award or other payment are available to pay for future medical items and services which are otherwise covered and reimbursable by Medicare.

Medicare is always a secondary payer to liability insurance (including self-insurance), no-fault insurance, and workers’ compensation benefits. The law precludes Medicare payment for services to the extent that payment has been made, or can reasonably be expected to be made promptly, under liability insurance (including self-insurance), no-fault insurance, or Workers’ Compensation (WC). (See Section 1862(b)(2)(A) of the Social Security Act, cited in the U.S. code at 42 U.S.C. § 1395y(b)(2)(A)(i)).

What are Medical Cost Projections?