Medical Providers

What Medical Providers Need to Know About MSAs

MSA Meds professionally administers Medicare Set-Aside (MSA) Accounts to ensure your patients protect their future Medicare eligibility for injury-related care. In most cases, medical bills paid from a MSA Account are paid at the same or greater rate than the pre-settlement reimbursement rate. This allows physicians to retain patients after the Workers’ Compensation or Personal Injury case has settled. Additionally, bills are usually processed much quicker and with fewer hassles than they were pre-settlement. Contact MSA Meds today at 855-MSA-MEDS to learn how you can retain your patients, get paid quicker with fewer hassles, and at the same time help your patients protect their future Medicare benefits.

What is a MSA Account?

The Medicare Secondary Payor (MSP) Statute provides that Medicare may not pay bills when there is a primary payor such as a Workers’ Compensation or Personal Injury Insurance Carrier who is responsible for payment. The MSP was enacted to prevent the parties from a Workers’ Compensation or Personal Injury settlement from shifting responsibility for the payment of future medical bills to Medicare and ultimately the taxpayers. The way that the parties protect Medicare’s interests in a settlement is through a tool called a Medicare Set-Aside (MSA).

A MSA is a projection of a patient’s future medical treatment related to the work injury or Personal Injury action that would otherwise be covered by Medicare. The projected future medical costs must be “set aside” in a separate account and used to pay bills for future injury-related care. Once the patient pays all bills according to Medicare’s strict rules and exhausts the funds, Medicare will begin paying bills for the injury. If the funds are not spent properly, Medicare will deny payment of injury-related care.

Some of Medicare’s strict rules require that bills paid from the MSA Account be paid according to Medicare’s approved price, which is usually the same as the pre-settlement rate paid. Also, only services that would be covered by Medicare may be paid from the MSA Account. Knowing the correct price to pay and researching Medicare coverage issues is a daunting task for most patients. If your patients make mistakes, they risk their future Medicare eligibility for injury-related care.

Our Services

MSA Meds offers professional administrative services for Medicare Set-Aside Accounts at no charge to you or your patients. We facilitate a continued relationship between doctor and patient while assuring physicians receive fair and timely compensation at the same or close to pre-settlement fees. Our team of MSA experts makes it easy for physicians to:

  • Retain their injury patients after settlement
  • Maintain an important revenue stream
  • Submit bills for payment
  • Generate fees at rates that are typically higher than Medicare reimbursements
  • Obtain timely prior authorization for services and procedures
  • Receive payment quickly and easily without the hassles of dealing with the Insurance Company
  • Ensure that patients receive MSA-compliant continued medical care from their known and trusted doctors

How to Bill Your Patient’s MSA Account

All bills related to the treatment of the patient’s injury should be submitted to MSA Meds on a CMS 1500 HCFA claim form. Please mail original bills to P.O. Box 190 Barnesville, PA 18214. To ensure timely payment, please remember the following:

  • Supporting treatment notes or medical reports must be attached.
  • The patient’s Date of Injury must be listed in box 14 or 15 on the CMS 1500 form.
  • A copy of the provider’s W9 must also be on file prior to payment. Please provide this information with initial billing.

** Please note: For services and medications where causation to the injury is unclear, a Letter of Medical Necessity (LMN) must be provided. The LMN is necessary to certify that the medication or treatment being rendered is reasonable and necessary for the patient’s injury. Delays in providing the LMN may result in delays in payment.**

How to Obtain Prior Authorization

MSA Meds understands that Medicare coverage issues are complex and oftentimes confusing. We will provide timely prior authorization for any treatment you are concerned may not be payable from the patient’s MSA Account. Click here to print a “Request for Prior Authorization of Treatment” form. Send completed forms by fax to 570-668-8825 or email to

The Benefits of Referring Your Patients to MSA Meds

At MSA Meds, we take pride in helping physicians and their patients gain a better understanding of the confusing post-settlement MSA Accounting process. MSA Meds ensures that your patients comply with the complicated Medicare requirements for MSA Accounts so that your patients’ future injury-related Medicare eligibility is not jeopardized. Although great care may have been taken to determine medical costs for the lifetime of the injury, MSA funds often run out and patients must depend on Medicare to pay their future bills. MSA Meds handles the complexities of MSA Account Administration to protect patients and ensure they receive future Medicare coverage. Our professional MSA Account administration is offered at no charge as a value-added service to clients of our pharmacy, which specializes in MSA-compliant prescription fulfillment to patients throughout the country.

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Contact MSA Meds

MSA Meds provides professional Medicare Set-Aside (MSA) Account administration that enables physicians to retain their injury patients post-settlement, and receive payment for their services quickly and easily. By providing Medicare Set-Aside Account administration at no charge, MSA Meds ensures a seamless post-settlement transition that facilitates continued medical services for injury patients and uninterrupted payments for their physicians. To learn more about our professional MSA Account Administration, our post-settlement pharmacy services, or how to refer a patient to MSA Meds, please contact us today.