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MSA projected Medicare Covered Items
#1
How does the MSA provider come up with the value of the Unit Cost for each provider services? The numbers I see are really low. Would this projected cost come from what Insurance pays for these services or the actual cost a provider would bill the Injured Worker?
If the costs are for what Insurance pays, then the MSA dollars would not cover the actual medical expenses. IE physician: Primary treating physician unit cost is $56.93. Chiropractic care $36.22. Where do they get these costs?
 
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#2
(09-27-2012, 05:31 PM)casual1 Wrote: How does the MSA provider come up with the value of the Unit Cost for each provider services? The numbers I see are really low. Would this projected cost come from what Insurance pays for these services or the actual cost a provider would bill the Injured Worker?
If the costs are for what Insurance pays, then the MSA dollars would not cover the actual medical expenses. IE physician: Primary treating physician unit cost is $56.93. Chiropractic care $36.22. Where do they get these costs?

They are discounted costs.

This is normally figured into the MSA account. CMS would have had to approve of the MSA amount to be funded to the account. Once the funds are exhausted; Medicare will then begin covering your expenses.
 
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