HomeProductMedicare Set-Aside Drafting
MEDICARE SET-ASIDE SOFTWARE
ROADMAP · PLANNED

The MSA allocation, drafted from the record — priced the way CMS actually reviews it.

Medicare set-aside software that drafts future Medicare-allowable treatment, by category, from the record's treatment trajectory and prices it at Medicare fee-schedule rates per CMS WCMSA methodology. The complete cited draft is ready for your certified MSA specialist's review and sign-off — certification and any CMS submission stay human.

AI delivers the complete cited draft behind an "Awaiting MSCC certification" gate — certification and any CMS submission stay human.
Adams, Timothy — right knee · Case #IME-4812 WCMSA draft
AWAITING MSCC CERTIFICATION
Allocation categoryBasisSource
Orthopedic follow-up visits MEDICARE FS p.14
Physical therapy course MEDICARE FS p.38
Prescription medications MEDICARE FS p.129
Every category — cited to the record Case #IME-4812
Medicare rates
Priced the way CMS reviews
Every category
Cited to the treatment record
MSCC gate
Certification stays human

Allocation categories from the trajectory, not a template guess.

WCMSA report software is a drafting engine: it reads the treatment trajectory already documented in the record — visits, orders, prescriptions, and where they were heading — and drafts future Medicare-allowable treatment by category. Each category carries citations to the visits and orders that support it, so your specialist reviews evidence, not assertions.

Categories grounded in documented treatment, cited per line
Nothing allocated that the record can’t support
Trajectory → allocation category
7 visits improving since 4/02 — ortho coursep.38
Active prescriptions in the current planp.129
Drafted category: future ortho follow-ups + RxCITED
The allocation follows where the record was already going.
Two documents · two pricing bases
WCMSA · THIS PAGE
Medicare fee schedule

Priced the way CMS reviews the allocation.

LIFE CARE PLAN
UCR · geographic

Priced the way the real world bills future care.

Opposite bases, on purpose — each matches its reviewer.

Medicare fee-schedule pricing — by design, not by default.

A Medicare set aside for workers compensation is reviewed by CMS at Medicare fee-schedule rates, so that is exactly how this draft is priced. It is deliberately the opposite basis from AI-Assisted Life Care Plan Drafting, which projects real-world future cost at UCR and geographic rates. Same record, two documents, each priced for the reviewer who actually reads it.

Per CMS WCMSA reference-guide methodology
The pricing basis is shown on every category

A draft behind a gate — until your specialist signs off.

MSA allocation drafting AI does the reading and the assembling; it does not do the certifying. Every draft carries a visible “Awaiting MSCC certification” status until a certified MSA specialist reviews and signs off, and any CMS submission stays with your team. The gate is part of the product — a draft is never presented as a finished allocation.

Visible certification gate on every draft
No CMS submission, no signed opinion — ever automated
Draft lifecycle · who does what
AI drafts the cited allocationAI
Awaiting MSCC certification — gate onGATED
Certified specialist reviews, signs off, submitsHUMAN
AI drafts. Humans certify and file.
The specialist’s review · with receipts
“Allocation per reviewer experience” UNCITED
Every category — visits, orders, and Rx cited CITED
Treatment the record can’t support — flagged, not allocated FLAGGED
A draft your specialist can verify line by line
The citation standard

An allocation your specialist can check against the record.

The slowest part of an MSA isn’t the pricing math — it’s establishing what the record actually supports. That is the part this does with receipts: every drafted category cited to the pages behind it, every unsupported item flagged instead of allocated. Audit-grade, source-linked, and built to survive the certifier’s red pen.

See Verifiable AI Citations

How it works.

Three steps between the claim file and a draft your certifier can work from.

01
Upload the claim file

Treatment records, prescriptions, and bills — the same file your other reviews already run on.

02
The allocation drafts itself

Future Medicare-allowable treatment by category, from the treatment trajectory, priced at Medicare fee-schedule rates — every line cited.

03
Your specialist certifies

The MSCC-certified reviewer works the cited draft, signs off, and handles any CMS submission. The gate lifts only then.

Who drafts MSAs with it.

The teams that settle workers’ comp claims with Medicare interests on the table.

FAQ

Medicare set-asides, answered.

Yes. It drafts the WCMSA allocation from the treatment trajectory already documented in the record, priced at Medicare fee-schedule rates, ready for your certified MSA specialist’s review and sign-off. Cost & Care Tables and Life Care Plan Drafting cover the adjacent future-cost documents built on the same record.

The current release targets the WCMSA — workers’ compensation Medicare set-asides drafted per CMS WCMSA reference-guide methodology, which is where CMS review expectations are most codified. Liability MSA support is being evaluated for a later stage.

Because the two documents answer different questions. CMS reviews a WCMSA allocation priced at Medicare fee-schedule rates, so that is how this draft is priced. A life care plan projects real-world future cost, so it uses UCR and geographic pricing. Deliberately opposite bases — each matching how its reviewer actually reads it.

No. It drafts the allocation from the record; certification by an MSCC-certified specialist and any CMS submission stay with your team. AI drafts, humans certify and file — that boundary is built into the product, not just the marketing.

Every draft carries a visible “Awaiting MSCC certification” status until a certified MSA specialist reviews and signs off. Until that happens the document is a working draft — clearly labeled, never presented as a finished allocation.

From the treatment trajectory already documented in the record: future Medicare-allowable treatment is grouped by category — physician visits, therapy, diagnostics, prescription medications — with each category cited to the visits, orders, and prescriptions that support it.

Related capabilities.

The future-cost and claims side of the same cited record — much of it available today.

See an MSA draft built from one of your own files.

This workflow is planned, not generally available. Book a conversation to discuss the intended CMS methodology, specialist-review guardrails, and roadmap timing.