The timeframe for preparing a Medicare Set-Aside (MSA) can vary based on several factors, such as the severity of injuries, case complexity, and the volume of treatment records involved. Typically, MSA vendors take between 3-5 business days under normal circumstances, although some may offer expedited "rush" services for faster turnaround.
Factors Influencing MSA Preparation Time
- Injury Severity and Case Complexity: More complex cases with severe injuries may take longer due to the need for detailed evaluation.
- Availability of Records: The speed at which treatment records can be obtained and reviewed directly impacts the MSA preparation time.
- Vendor Efficiency: Different MSA vendors have varying standard processing times.
Standard Review Time by CMS
For the Workers’ Compensation Review Contractor (WCRC) to review an MSA, it typically takes an average of 30 days if there are no issues in case development. However, the Centers for Medicare & Medicaid Services (CMS) specifies that the review process can extend to 45 to 60 days once all relevant documents are submitted.
Additional Details
For comprehensive information on official CMS timeframes, refer to the WCMSA Reference Guide, v.3.1, sec 15.1.
