Medical Cost Projections

Medical Cost Projections

Medical Cost Projections are prepared by either a registered nurse, Certified Medicare Set Aside Consultant or Certified Life Care Planner, through a comprehensive analysis. Medical Cost Projections are case-specific, dependent on the claimant’s medical needs. The following records and documentation are required: Two years of medical records, Two years of pharmacy history, and Claim payment history
TrustToss takes Medicare into account through the following services:
MCP Update:
TrustToss will provide updates and revisions on all MCPs upon request. The following records are required:
  • Current treatment records
  • Current pharmacy records
  • Current two year all-inclusive payment history
MCP to MSA conversion:
Upon request, our team at TrustToss will convert any MCPs to a MSA. To do this, the following documents are required:
  • First report of injury
  • Two years of medical records
  • All surgical, procedure, Car Scan and MRI reports (life of claim)
  • Two years of pharmacy history
  • Two years of all-inclusive payment history, organized by medical, identity and expense
  • Claimant-signed consent to release
Life Care Plan:
Life Care Plans indicate future treatment costs that an individual may need over the course of their lifetime. These reports are extremely detailed and client-specific. To prepare this, the following documentation is required:
  • All medical records (life of claim)
  • Claim payment history
  • Pharmacy history
Conditional Payment Identification:
When an injured worker is a Medicare beneficiary, there’s a potential for conditional payments. In this case, any injury-related payments made by Medicare are done with the expectation that there will be reimbursement. Our team at TrustToss works with the BCRC/CRC to begin this process for you. To do so, the following records are required:
  • Claimant-signed proof of representation
  • Carrier-signed letter of authorization
  • Claimant’s current address, date of birth and date of injury
  • Compensable Body Part(s)
  • Description of injury
  • Carrier name and contact information (address, phone and fax)
  • Attorney information, if available
Conditional Payment Dispute/Resolution:
To help you resolve any conditional payment disputes, our team can make a comprehensive report of CMS itemized medical payment made by Medicare of which to expect reimbursement. These unrelated charges will then undergo a formal dispute to the BCRC/CRC for determination of removal. To prepare this, the following document are required:
  • Claimant-signed proof of representation
  • Carrier-signed letter of authorization
Final Document Submission:
All final documents can be formally sent to the appropriate Medicare Contractor, upon request.
Medicaid Services:
Our team at TrustToss offers complete Medicaid resolution services depending on your needs including identification, disputes and negotiation. To do so, the following documentation is required:
  • A signed HIPAA release
  • Signed proof of representation
  • Letter of Authority
  • Medical records, judgments or awards
Medicare Check:
To verify Medicare Beneficiary status and eligibility, we require the following information:
  • Claimant name
  • Current address
  • Date of birth
  • SSN
  • Responsible reporting entity number (RRE#)
Social Security Disability Verification:
To verify Medicare or Social Security Disability status, a signed SSA-3288 release is required.
Rated Age Evaluation:
A rated age evaluation is done to provide an appropriate life expectancy for allocation. To complete a rated age evaluation, our team will complete a comprehensive review of all medical records, which will be submitted alongside documentation for evaluation. Claimant medical records are required for review.