Clinical Disability Claim Methodology

MedAssist is one of the nation's leading experts in disability claims processing. Our nationwide footprint and extensive efforts to establish strong relationships with SSA staff has helped facilitate the approval of millions of disability claims

• MedAssist has a Department of Government Affairs (DOGA), which is devoted exclusively to SSA's disability programs and employs former high level personnel from the Social Security Administration.
• DOGA implements a state-of-the-art, on-site, training process for all Eligibility/Operations staff.
• MedAssist is a Gold Corporate Member of the National Association of Disability Examiners (NADE).
• MedAssist is on SSA's National Provider List as a company doing business with federal disability decision makers at the national level (i.e. in Baltimore).
• MedAssist facilitates client participation in SSA's national initiative on electronic medical evidence (EME).
• We offer on-site training seminars covering federal disability programs to health care providers.
• MedAssist has implemented a "Fast Tracking" program that accelerates presumptive benefits, terminally ill and Medical Improvement Not Expected cases.

DOGA deals specifically with the Disability Determination Units across the country to provide more fruitful relationships between the two agencies. Interaction with these agencies ensure that MedAssist always uses the correct applications and forms mandated as well as follows proper procedures and protocol for accurate and timely disability claims processing.

MedAssist takes immediate action on the application process for patients that qualify for SSI/SSD, securing the application either by telephone or in person with the SSA. Patient signatures on a Release of Information and a SSA Form 3288 are obtained to enable MedAssist to follow-up with DDU and the SSA for status updates on the patient's claim.

MedAssist encourages the appeals process and procures the appropriate forms, medical records etc. that are required to pursue the appeals process. MedAssist establishes communications with the SSA and DDU offices and receives direct status updates on claims and copies of patient correspondence to include doctor's appointments, decisions, hearing dates, etc.

Should the patient's claim require a hearing before an Administrative Law Judge (ALJ), MedAssist will help the patient find an attorney that specializes in disability claims with the SSA.

MedAssist will then establish direct communication and follow-up that includes the patient's attorney.

In addition, during the entire SSI/SSD process, MedAssist will network with the patient's physicians and facility providers to gather outstanding medical bills and medical records for DDU Examiners and/or the representing attorney. MedAssist provides "free" transportation to the patient to SSA appointments, SSA required doctors office visits etc. And, because of the follow-up technology, MedAssist has the ability to remind the patient of upcoming appointments relative to their application/claim.

Dually Eligible Patients

Some patients may be eligible for both Medicaid and SSI/SSD. Many states allow for potentially eligible patients to have an application pending for both programs. In the event that a patient has been identified as "dually eligible", MedAssist will walk the patient through both application processes and continue the same detailed filing and follow processes on the individual applications.

MedAssist staff is experts in dually eligible programs and are well aware of the nuances. They strive to achieve two goals: helping the patient obtain the maximum benefits available to them and their families with their medical card and to generate reimbursement to the hospital as quickly as possible.