By law, medical assistance forms must be sent to a SSA office before you can receive reimbursement for your employee’s medical expenses. Here are some things to remember when it comes to medical assignments:
* Medical assistance Form 1177s are sent to SSA office before claims are processed. If you have more than one employee, the assignment must be on the same date to ensure proper filing of your claim. You should send all forms to the SSA office during one month so that claim processing time is not delayed.
* The SSA assists your insurance company in assigning the case. Your representative will meet with the claimant to discuss medical records and any other information that is needed to properly assign the case. Your representative will also discuss treatment options with the claimant. An assigned doctor will provide a written opinion of the claimant’s condition and help determine an appropriate course of treatment.
* The claimant can ask for a second medical claims assignment by writing to the SSA. The SSA will ask the physician to send a revised assignment to your office, which the SSA will review. The claimant will then get a new assignment.
* A claimant cannot request a medical assistance form outside of the submission period. Each assignment must be submitted within six weeks of the date it was received by the agency. If the claimant requests a medical assignment during the six-week period and the office does not receive the forms from the agency, they are required to forward the forms to the agency.
* There are times when a claimant has a problem with the claim. Your representative may review the claim. After reviewing the case, your representative will send a letter of determination that includes the recommended treatment and your letter of determination that states that you are accepting the claimant’s claim. Your representative will provide the claimant with the medical assignment help form, the medical assignment form, and a copy of the SSA letter of determination.
* Any subsequent adjustments will be made by your representative after reviewing the medical assistance form and requesting a second medical assignment. Your representative may not act as the settlement agent, and they will sign a medical assignment help form only if they agree with the evaluation letters. Each assignment is assigned on a first come, first served basis.
* The most common claim is a claim for cancer. To determine the type of cancer a claimant has, the claimant is asked to identify the number of moles on the face, neck, back, shoulders, and hands and the location.
* It is important to make sure the claimant receives adequate treatment for their cancer. Your representative will contact the claim administrator if a settlement agent is needed. A settlement agent will negotiate on behalf of the claimant with the insurance company.
* The settlement agent can also be contacted by your representative to make sure the claimant’s medical needs are being met. The settlement agent is not allowed to make decisions about the treatment of the claimant or the payment.
* During a medical assignment, the claims adjuster will make every effort to accommodate the insurance company and to make sure the claimant’s needs are being met. The claims adjuster will be scheduled by the SSA to make all medical appointments, and will file the claimant’s claim. A second appointment is scheduled by the claimant to be examined by the settlement agent and a second assignment is arranged to provide a second opinion on the claim.