Medicare Set-Aside allocation
Future medical costs projected from medical records, ICD-coded, priced against fee schedules, and submitted in CMS format — all present, or the package does not release.
The most rigorous MSP compliance package a claims leader can buy.
The MSP Settlement Clearance Engine assembles a settlement-ready compliance package — CMS-defensible Medicare Set-Aside allocation, resolved conditional-payment/lien demand, and Section 111 reporting data — checked against the Medicare Secondary Payer Act and CMS guidance before a certified professional releases it.
Every applicable subsection of 42 U.S.C. §1395y(b)(2)Three compliance pillars: MSA, lien, Section 111Medical-record extraction · ICD mapping · Rx projectionCertified MSP professional + attorney release5-business-day SLA
Why packages fail
A single missing element can trigger civil money penalties and block settlement closure.
Every workers' comp settlement involving a Medicare beneficiary triggers a federal compliance gauntlet: protect Medicare's future interest with a Medicare Set-Aside, repay Medicare's past conditional payments, and report the settlement under Section 111. Miss any element — or get the allocation wrong — and the claim cannot close, exposing the RRE to $250/day in civil money penalties per claim, capped at $365,000 per claim per year, plus double-damages liability for unresolved conditional payments.
Most claims organizations run this by hand, from memory, once or twice a year. The statute has not been read end-to-end since the last time it mattered. That is exactly where completeness gaps hide.
The MSP Settlement Clearance Engine exists to close that gap with a single, exhaustive standard applied identically to every file.
$250/day
civil money penalty per claim for non-compliance
The benchmark
Measured against the letter of the MSP Act and CMS guidance — subsection by subsection.
We do not summarize the law and hope. Every package is scored against a versioned rule pack tied to the exact text of the Medicare Secondary Payer Act and CMS WCMSA Reference Guide. These are the provisions each package is held to.
Conditional payment resolution
BCRC/CRC ledger reconciled line-by-line, unrelated charges disputed, final demand obtained — verified to the penny.
Section 111 reporting data
All required data fields for NGHP reporting, including MSA detail and zero-dollar allocations per April 4, 2025 mandate — assembled and audit-ready.
Life-expectancy rating
Rating methodology documented and applied by a certified professional; deterministic gates verify consistency with CMS guidance.
Civil money penalty avoidance
Compliance checklist verified against CMP exposure triggers; any gap blocks release.
Submission formatting & thresholds
Allocation formatted per CMS specifications; workload review thresholds ($25K/$250K) applied correctly; submission package complete.
How a package is built
Intake to certified professional release, with deterministic gates the AI cannot overrule.
AI extracts and drafts. Deterministic rules — running as code, outside the model — decide what is complete. A certified MSP professional and attorney sign every release. That order is never reversed.
01
Completeness Gap Scan
Upload the claim file and settlement details. We return a free completeness read: which statutory elements and searches you already have, and which are missing.
02
Medical record extraction & ICD mapping
As your authorized clerical agent, we extract diagnoses, treatments, and prescriptions from medical records, map to ICD codes, and build a treatment projection.
03
MSA allocation drafting
Future medical costs are projected against fee schedules and pricing tables, life-expectancy rated, and assembled into a CMS-formatted allocation report.
04
Conditional payment reconciliation
BCRC/CRC ledger is reconciled line-by-line; unrelated charges are identified for dispute; final demand is obtained.
05
Deterministic completeness gates
Allocation amounts reconcile to projections; Section 111 fields are validated; CMP checklist is resolved; any failure blocks release.
06
Certified professional & attorney release
A certified MSP professional reviews the exception queue and signs the release. Attorney review is included for legal interpretation of reportability and dispute strategy.
07
Delivery
You receive the package: MSA allocation report, lien resolution documentation to final demand, Section 111 data file, audit trail, and compliance checklist — ready for the RRE to submit.
The bar we hold
Rigor you can measure.
100%
Certified professional-released
No package ships without a human signature.
5 days
Standard SLA
From complete intake to released package.
<1%
Critical-defect target
Tracked against a gold-standard package library.
3
Compliance pillars
MSA · Lien · Section 111, every applicable file.
Why MSP Settlement Clearance Engine
Built to be the most thorough option a claims leader has.
Documentation-complete, by design
The deliverable is completeness itself — every statutory element and search accounted for or explicitly exception-coded. Nothing is left implicit.
Deterministic, not vibes
The gates that decide completeness are code, not a model's opinion. A drafting error cannot slip past a statutory requirement.
In its lane, on purpose
We prepare documentation and run searches as your clerical agent. We never give legal advice, contact the beneficiary, or settle the claim.
Engagement
Flat fee, per released package. No contingency, ever.
Simple, predictable, and aligned with a documentation standard — not a cut of any recovery.
- A free Completeness Gap Scan before you commit — see exactly what is missing.
- One flat fee per released Settlement Clearance Package; disclosed pass-through search fees.
- Optional fixed-fee attorney review for complex legal interpretation or dispute strategy.
- Optional Sale Continuity Add-on for Section 111 submission and post-settlement monitoring.
FAQ
Questions, answered precisely.
Is MSP Settlement Clearance Engine a law firm?
No. MSP Settlement Clearance Engine, a service of Your Deputy, Obuke LLC, provides documentation-completeness services. It is not a law firm, does not provide legal advice, and does not represent you in any legal matter. Attorney review is included for legal interpretation of reportability and dispute strategy.
Do you contact the beneficiary or collect the debt?
Never. MSP Settlement Clearance Engine is not a debt collector and does not contact Medicare beneficiaries or claimants. The RRE remains the party responsible for all communications and submissions.
What makes a package 'complete'?
Completeness is defined by the MSP Act and CMS guidance: the three compliance pillars (MSA, lien, Section 111) present, all statutory elements verified, conditional payments reconciled, and CMP checklist resolved. Deterministic gates enforce each one before release.
How fast is it?
The standard SLA is five business days from complete intake to a certified professional-released package. The free Gap Scan is returned much sooner and tells you exactly what is still needed.
How are you priced?
A flat fee per released package, plus disclosed pass-through search costs. No contingency and no percentage of any recovered amount or settlement proceeds.
See what's missing before it costs you a penalty.
Start with a free Completeness Gap Scan. Send your claim file and settlement details and we'll return a completeness read against every applicable subsection of the MSP Act and CMS guidance.
Documentation-completeness service · not legal advice · the RRE submits every filing.