A file review is the first step in progressing towards case closure.

MSA Plus provides a comprehensive review of a file that includes a brief summary of treatment to date (usually the last 2-3 years unless an extensive review is requested) which outlines current diagnosis and medications.  Treatment patterns, missing records, and issues are identified followed by recommendations for the file that will assist with any/all of the following:

  1. Clarify current treatment plan from physician, including meds, with specific type, frequency, and duration
  2. Clarify future cost of case, including medications
  3. Reduce cost/exposure
  4. Clarify relatedness and causality
  5. File Closure

Once it is determined what recommendations are needed for the file, a prioritized action plan is implemented that may include any/all of the following:

  1. Assign Field or Telephonic Case Management for specific task completion
  2. Assign full Field Case Management
  3. Complete a Medical Cost Projection
  4. Complete a Medicare Set-Aside
  5. Complete a Life Care Plan
  6. Obtain a Drug Utilization Review
  7. Obtain a Peer Review
  8. Obtain an Independent Medical Exam

As the action plan is implemented ongoing updates will be communicated outlining the current status and the next steps to be taken.  Upon completion of the recommended action plan a final report is provided summarizing the steps implemented, the outcomes achieved, and identifying potential cost savings.