CareGuard members receive a settlement fund for their work related or liability injury. Typically, members receive a seed amount to start their fund and then receive a yearly annuity. If a member exhausts their funds prior to receiving their next annuity payment, you will receive an Explanation of Reimbursement (EOR) stating “Funds Exhausted, Bill Secondary.”
At this point, you should contact your patient for secondary insurance information and resubmit the claim. If your patient has Medicare as their secondary insurance, you will need to submit the claim to Medicare with a copy of our EOR included. Please continue to submit all future bills to CareGuard even after receiving a Funds Exhausted EOR. This ensures that we will be able to supply you with the correct EOR documentation for Medicare (if necessary) and that we will seamlessly begin paying as primary once funds are replenished.