Your Medicare Compliance Solutions Partner

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Win the battle against high projected MSA exposures

Successful Claim Outcomes: Case Study – Meet Ms. Pratt

In October 2004 Ms. Pratt reported that as she sat down in a chair at her place of employment and the seat broke, causing her to fall to the floor. She had initial complaints of low back pain. Ms. Pratt ultimately underwent a lumbar laminectomy at L4/S1. An epidural steroid injection was administered and in 2010 Ms. Pratt underwent an anterior lumbar interbody fusion at L4/S1, followed by an anterior lumbar interbody fusion at L2/S1 later that same year. In 2014 she underwent an L2/L3 anterior interbody arthrodesis with allograft and instrumentation. Later that year she underwent hardware removal due to nonunion and loosening of L3 pedicle screw. Ms. Pratt had a 32 year life expectancy. An MSA was completed by a different MSA provider. That MSA allocation came back at $618,434. Axiom was asked to get involved and complete a second MSA based on the same exact medical documentation two months later. After consultation with our client and defense counsel, clarification from the primary treating physician on several key issues and a comprehensive analysis, Axiom completed an allocation which was approved by CMS as submitted in the amount of $193,606, resulting in a substantial savings for our client.

Initial MSA Total: $618,434 Axiom Approved MSA Total: $193,606

 

Total Savings $424,828!!!

Axiom National, LLC
13046 Race Track Road, # 277 Tampa,
FL 33626

(888) 826-6496 Ofc
813-600-0704 Mobile
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ghudson@axiomnational.com
www.axiomnational.com
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