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Any RPA developer with ctc 30lpa here?
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No. They really can only demand payment for treatment that was presented in the demand as a part of the claim.
The caveat to this is they must have been given notice of the settlement and evaluated any potential liens for past and potential future treatment and you should’ve obtained a response before paying your client. Most insurance companies will force you to do this as part of the settlement but I can’t see why Medicare would do this unless they had not yet issued a final letter when the insurance company paid your office/client.
Medicare set aside (future medical care) is an issue that needs to be addressed and you need to get a final demand amount from Medicare for past medicals when the case settles.
You need to look at Medicare Set Aside Trusts as Medicare could refuse to pay for future treatment, you need to evaluate this when settling a case, the issue is CMS has not set in stone procedures for this only for Workers Comp cases
The point of reimbursement is for them to recover money that they paid out which was then recovered from the tort feasor. Not necessarily to recover money for all treatment that was incurred. They can’t recover money that the client was never paid.