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Medicare compliance 
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/ > Integrated services > Medicare compliance
With confusion over requirements and severe penalties, Medicare compliance may be one of the costliest headaches clients face today. At Sedgwick, we provide comprehensive Medicare compliance services as an in-house, integrated program option for our workers’ compensation and liability claims management clients.
Our Medicare compliance solution includes Medicare set-aside determinations, medical cost projections, Medicare conditional payment or lien negotiation and resolution and related consulting services. Our costs are, on average, 15 to 20% less than leading competitors with the added advantage of a fully integrated claims program, superior quality and greater efficiency.
By utilizing an integrated Medicare and claims solution our clients gain immediate access to important data. Our process also provides efficiencies by delivering services with a shorter turnaround time than other vendors. And clients feel confident in the quality and security Sedgwick’s Medicare compliance services deliver. Our value proposition includes an expert team of industry and claim professionals; the knowledge and confidence that sensitive medical documents and personal information never leave Sedgwick; and the assurance that our overall goal is to drive total claims costs down.
In fact, last year, we turned away 11% of claims our examiners submitted as needing MSAs – that’s business we turned away to save our clients money. Sedgwick's Medicare compliance difference:

  • Focuses on reducing the total cost of all your claims;
  • Ensures claims are submitted accurately and completely the first time;
  • Reduces work for examiners, so they can focus on critical issues and not administrative tasks;
  • Provides examiners with detailed recommendations to assist in reducing the MSA;
  • Updates MSA at time of submission at no charge, and... no hidden fees or costs are associated with the MSA.