Represented and Unrepresented Claimants

Unrepresented claimant cases pose unique concerns for the claims professional. On the one hand, their job is to review the claim, make appropriate adjustments to the claim, and resolve the claim as quickly, efficiently and effectively as possible. Accomplishing those goals necessarily means addressing Medicare compliance and lien resolution issues head-on. On the other hand, there’s a line between claimant and adjustor that cannot be crossed. The claims professional does not represent the unrepresented claimant, and cannot provide that claimant with legal advice. Under no circumstances can it be alleged that the claims professional or the organization be accused of the unauthorized practice of law in handling Medicare compliance and lien resolution issues on the claim.

Cattie & Gonzalez solves that dilemma. Our firm can serve as the go- between for the claims professional and the claimant. Hired for the sole purposes of handling Medicare and Medicaid compliance and lien resolution issues, Cattie & Gonzalez can communicate with the claimant and provide legal advice about reimbursing Medicare/Medicaid and other lienholders that the claims professional cannot. When our work is done, reporting and reimbursement obligations are addressed compliantly, claims can be resolved without jeopardizing the claimant’s eligibility for Medicare, Medicaid, or other health insurance.

Our services may be provided on cases involving unrepresented claimants just as they can when the claimant has decided to hire counsel. Parties to a claim may also decide to hire Cattie & Gonzalez jointly. Since it is true that addressing Medicare and Medicaid compliance and lien resolution issues benefits all parties trying to resolve a claim, we have cases where the parties agree to split our firm’s fees. By doing this, all benefits of the firm’s work flows to all parties. Importantly, this also includes the protection provided by services such as our Future Medical Projections and MSA Legal Opinion.