Our Insights

If medical records feel like a foreign language or opposing experts sound like they’re reciting Latin, you’re not alone. Legal Nurse Consultants (LNCs) are the missing link—registered nurses with legal savvy who decode healthcare data into actionable legal strategy.   Why Legal Teams and Insurance Carriers Trust LNCs   1. Medical Record Forensics   No […]

🚨 The Case of the Unnecessary Transplant Picture this: A middle-aged woman with post-COVID cardiac complications. A shocking recommendation for a heart transplant buried in her records. A price tag of millions added to her Medicare Set-Aside (MSA). But here’s the twist: the suggestion came from an internist, not a cardiologist—and it was about to […]

In the dynamic world of governmental oversight, managing risks and reducing errors are crucial for ensuring compliance. Recently, these risks have become more pronounced in the Medicare Secondary Payer arena due to increased governmental scrutiny and new legal enforcement measures. Even minor typographical errors can lead to penalties and other significant liabilities. Our most recent […]

A message from Allan Koba Principal, Ciara Koba   Growing up, my oldest sister was the kind of environmentalist who made you side-eye her choices (lovingly, of course). Case in point: When she visited me in Pittsburgh years ago, she met with an engineer that built her a car that ran on used cooking oil […]

Already off to a hot year in WCMSA updates, CMS kicks off Q2 with another round of new information for the Medicare Secondary Payer community. Workers’ Compensation Medicare Set-Aside Reference Guide Version 4.3 published April 7, 2025 serves up the awaited language associated with the Amended Review timeframe elimination, as well as a Change of […]

All the talk these days of CMS eliminating waiting periods for Amended Review of an MSA has cast a shadow on its predecessor – the Re-Review process. If you get a result from CMS and don’t want to bite the one-time Amended Review apple just yet, Re-Review is alive and well and yielding results. This […]