MSA Custodial Product Suite
These products and services protect and extend the financial benefits allocated for Medicare Set-Aside (MSA) in a Workers’ Compensation claim. Understanding the jurisdictional and regulatory requirements, and then managing costs to slow the withdrawals from the trust fund, will enable the benefits to last longer and be more effective for the injured worker’s overall health.
Some of the unique values that PRIUM provides are:
Drug Card
Network depth - Over 64,000 pharmacies nationwide
Access – Immediate access to prescriptions via Retail or Mail Order
Discounts – Negotiated discounts to ensure the best possible price
Limited Out-of-Pocket – Removes the need for injured worker payments
Bill Review
Control – Assures pricing is reasonable and within U&C (Usual & Customary)
Fraud detection – Proactive monitoring for fraud and prompt notification
No Risk – No savings, no cost
Price Negotiation
Negotiation – Pre-negotiated costs on expensive procedures
No Risk – No savings, no cost
Other applications – Available as a standalone service outside of this claim
Focused - Strategic and tactical focus on Workers' Compensation
Integrated Utilization Review - Monitoring opportunities for pain management optimization
Clinical oversight - Physicians (nationwide, multi-discipline, active-practice) involved in the UR process
Actionable sentinel - Proactive identification of outlier claims (by trends and Evidence Based Medicine) to create management action plans
TEC – Embedded Therapeutic Equivalent Conversion program
POPProvider Outreach Program, proactive TEC
Compliance – Ensures proper paperwork and best practices are maintained for the trust fund
Quality - PRIUM has been accredited by URAC since 1997