Synergy’s blog brings you the industry’s foremost thought leadership InSights on matters of healthcare lien resolution and Medicare Secondary Payer Compliance. Visit often to discover helpful InSights on important lien resolution compliance issues.
Synergy negotiated directly with the Plan Administrator and within three (3) weeks had secured a reduction of 50% from Plan Administrator. This was savings of $13,334.59 to the injured plaintiff.
The Federal Employees Health Benefits Act (FEHBA) of 1959 (5 U.S.C. 8901 et seq.) is the largest employer-sponsored group health insurance program in the world, covering more than 8 million federal employees, retirees, former employees, and family members. FEHBA Plans are contracts between the insurance carrier and the United States Office of Personnel Management (OPM).
An Administrative Services Agreement between a Plan Administrator and a Claims Administrator may fall within the purview of a document request under ERISA 29 U.S.C. § 1024(b)(4), with non-compliance subject to the penalty assessment authorized under ERISA 29 U.S.C. § 1132(c). As Synergy has long advocated, one of the keys to properly defending against an asserted subrogation or reimbursement claim from an ERISA plan is making requests to the plan administrator.
Synergy allows trial lawyers to focus on what they do best. Our entire team is made up of experts who can help resolve the most complicated issues at settlement. Synergy’s executive team brings an unparalleled amount of experience to assist you at settlement.
Synergy successfully employed the Medicare appeals process and obtains a 100% reduction of Medicare’s Final Demand. After submitting consecutive appeals Synergy was successful in having MSPRC agree to reduce the demand amount to zero ($0.00) and issue a refund in the amount of $16,019.73.
Recently there has been some confusion caused by the Florida Bar introducing subsection (E) to Rule 4-1.5(f)(4) and its application to non-lawyer lien resolution companies. Subsection (E) was approved by the FL Bar Board of Governors at their meeting on May 31st and the rule now awaits adoption by the Florida Supreme Court. The confusion, though not unexpected, is clearly resolved by a plain reading of the comment to this proposed amendment.
This case involved a Virginia plaintiff who was injured when a shower chair collapsed. The plaintiff had a pre-existing hip injury which involved an implanted prosthetic. Plaintiff’s counsel engaged Synergy Lien Resolution Service to assist in the resolution of the ERISA plan’s reimbursement claim. Despite the unfavorable law in the 4th Circuit, which was recently bolstered by U.S. Airways v.McCutchen, within two (2) weeks Synergy was able to obtain a 70.2% reduction for a savings of $85,955.02.
Medicare Advantage plans, otherwise known as Medicare Part C, have proven to be a hot and confusing topic for plaintiff’s attorneys over the past few years. Recent rulings by the U.S. Supreme Court and 9th Circuit have done little to eliminate this confusion. Instead, the latest
case law has increased the complexity.
Read more about it
This case involved an elderly plaintiff who had Medicare Part C coverage
through his AARP Medicare Advantage plan. Synergy applied its proven tactics and within forty five (45) days had reduced the claim to $2,690.40. This is a reduction of almost 95% which created a savings of $48,978.94 allowing the injured plaintiff to retain over 80% of his net recovery.