MersbrEle
Ennis
Ennis
NORTH DAKOTA
123134
Attaiva@sqmail.xyz
89838584618
89777443935
Defense Attorney
MersbrEle
1
6759
Ennis
Ennis
TENNESSEE
122341
1978-12-12
1890
Ireland
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MersbrEle
Ennis
Ennis
OHIO
125231
81854384144
MersbrEle
Ennis
Ennis
IDAHO
123243
Attaiva@sqmail.xyz
82811955975
86215472461
MersbrEle
Ennis
Ennis
HAWAII
145252
Attaiva@sqmail.xyz
87476889122
89673444429
MersbrEle
Ennis
Ennis
WEST VIRGINIA
112212
Attaiva@sqmail.xyz
89334743482
82287177635
Medical Cost Projection: For valuing claim and setting reserves - does not include MSA analysis. Release forms not required. Option to convert to MSA available.
Determine Medicare status: Includes verification thru SSA inquiry of Insured&#039;s SSDI and Medicare status and legal opinion regarding whether or not a MSA is recommended. Claimant&#039;s signed SSA release form is required.
Submit proposed MSA to CMS: Submission of completed MSA and supporting documentation to CMS for approval. Claimant&#039;s signed Consent Form required.
Complete MSA Bundle: Includes verification of Claimant&#039;s SSDI and Medicare status, completion of MSA, conditional payment research, submission of MSA to CMS for approval. Claimant&#039;s signed Consent Form and SSA Release are required.
Compromise of Medicare&#039;s Conditional Payment: Includes legal argument to support request for reduction or waiver of CMS conditional payment recovery claim; Claimant&#039;s signed Consent Form required. Hourly charges applied.
Request for CMS approval of Waiver of MSA ($0 MSA): Additional documentation may be required. Claimant&#039;s signed Consent Form required.
SUBMIT
11
5.188.48.10
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https://manleyandassociates.com/workers-compensation-claim-forms/
July 20, 2021
8:03 am
Manley &amp; Associates
https://manleyandassociates.com
takamatsu@manleyandassociates.com