We offer complete Medicare Secondary Payor Compliance resolutions for all insurance lines of business

Workers Compensation and Medicare Set Aside Consultants

Compensation For Workers And Medicare

We offer complete Medicare Secondary Payor Compliance resolutions for all insurance lines of business.

Please grasp your rights and privileges to ensure you can fully leverage the benefits rightfully yours. Moreover, companies are legally obligated to furnish proper compensation to employees when required. Capstone is your ally in comprehending the intricacies of processes, including Medicare Set Aside and medical case management, making the journey more accessible, streamlined, and yielding optimal results.

We offer easier access and procedures for compensation for Medicare and workers.

Please grasp your rights and privileges to ensure you can fully leverage the benefits rightfully yours. Moreover, companies are legally obligated to furnish proper compensation to employees when required. Capstone is your ally in comprehending the intricacies of processes, including Medicare Set Aside and medical case management, making the journey more accessible, streamlined, and yielding optimal results.

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About Us

Capstone Medicare & Workers Compensation Consultants.

Capstone specializes in offering Medicare Set-Asides and Workers Compensation Consulting Services. Our delegation is to deliver high-quality services and furnish precise projections. We offer an inclusive range of services specifically designed for complex case resolution, ensuring compliance and healthcare MSP (Medicare Secondary Payer) standards are met.

Services

We are a team of professional consultants who prioritize your needs above everything else.

Medicare Set-Asides

Medicare Set-Asides (MSAs) stand as the recommended approach for safeguarding Medicare's interests in settlements related to workers' compensation, auto, and liability cases.
Medicare Set-Asides (MSAs) stand as the recommended approach for safeguarding Medicare's interests in settlements related to workers' compensation, auto, and liability cases.
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CMS Legal Submission Services

Our comprehensive CMS submission services encompass the preparation of documents for submission to CMS
Our comprehensive CMS submission services encompass the preparation of documents for submission to CMS, facilitating electronic submission through the WCMSA Portal, and maintaining ongoing communication with CMS until approval is secured. It ensures compliance with regulatory requirements.
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Life Care Planning

Our life care plans involve a meticulous analysis of treatment needs throughout an individual's lifespan.
Our life care plans involve a meticulous analysis of treatment needs throughout an individual's lifespan. By employing a consistent scientific approach, we project care for those catastrophically injured, ensuring comprehensive and proactive support.
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Medical Cost Projections:

Capstone, LLC conducts Medical Cost Projections, offering a summary of medical records for both Medicare and non-Medicare future expenses
Capstone, LLC conducts Medical Cost Projections, offering a summary of medical records for both Medicare and non-Medicare future expenses. Our services include a thorough review of medical and prescription treatments, aligning with compliance standards.
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Case Management Services:

Capstone excels in providing case management services tailored for catastrophic and medical fields. We coordinate and collaborate with all treating providers,

Case Management Services

Capstone excels in providing case management services tailored for catastrophic and medical fields. We coordinate and collaborate with all treating providers, ensuring a cohesive approach for quality outcomes. Our private case management services prioritize compliance as a service, aligning with healthcare MSP regulations.
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Biography

Monica A. Williams, RN, CCM, CRRN, LNC, MSCC, CMSP, boasts an extensive background with over 25 years of experience in Managed Care and Workers’ Compensation. Serving as the President of Capstone Care Services, a Southeast Regional Case Management Company, Monica specializes in Catastrophic Field Case Management, Medicare Set Asides, Medical Cost Projections, MSP Compliance, Life Care Plans, and Complex Case Reviews. With a national reach spanning 15 years, she has been instrumental in providing comprehensive services. In her previous role as the Medicare Compliance Manager for Innovative Claims Strategies (ICS), Monica demonstrated proficiency in overseeing the Medicare Set Aside Program, encompassing CMS Legal Submission and Conditional Payment Resolutions. As the Manager, she developed and implemented internal processes and workflows for the Medicare Compliance Department.

Monica’s clinical expertise as a nurse lies in Neuro Intensive Care, Cardiac Intensive Care, and Orthopedics. Her career includes a significant stint as a case executive for Blue Cross Blue Shield of Columbus, Georgia, followed by roles as the District Manager for Georgia and the National Catastrophic Program Manager for Intracorp, a former division of CIGNA, spanning 13 years. A graduate of Jacksonville State University with a B.S. in Biology/Sociology and Nursing, Monica completed one year of the master’s in nursing program at Troy University. She holds certifications as a Certified Case Manager (CCM), Certified Rehab Registered Nurse (CRRN), Legal Nurse Consultant (LNC), Medicare Set Aside Certified Consultant (MSCC), and Certified Medicare Secondary Payor Compliance (CMSP). She is recognized as a Georgia Catastrophic Supplier.

Monica is an active participant in professional associations, contributing her expertise and leadership to the healthcare community. She is a member of the American Association of Nurse Life Care Planners and holds a Board Member position for the National Association of Medicare Set Aside Professionals (NAMSAP). Monica’s contributions extend to various committees within NAMSAP, including the Annual Conference Committee, Liability Committee, and Evidence-Based Medicine Committee, and she serves as the Co-chair of the Membership Committee.

Monica is not only a healthcare professional but also a dedicated educator. She takes great pleasure in teaching nurses about the complexities of the case management process and guiding them in the business arena. Monica has led webinar training sessions for large third-party payer and employer groups on Medicare Secondary Payor Compliance. As a recognized speaker, she imparts her knowledge on Case Management across the continuum for all lines of insurance business, Medicare Set-Asides, and Medicare Secondary Payor Compliance.

About Us

Why us?

  • High-Quality Consulting

    Our company specializes in providing high-quality consulting services, with a strong focus on delivering exceptional Medicare set-aside and Worker's Compensation solutions.

  • Experienced

    With more than 19 years of experience in medical management, our goal is to achieve cost-efficient outcomes while providing exceptional customer service.

  • Customer Experience

    Our dedication to the customer experience is evident in our proactive approach to addressing your queries and concerns promptly, ensuring your satisfaction with the comprehensive solutions we offer.

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Testimonial

What our patients say

Exceptional service! The team at Capstone provided invaluable assistance with our Medicare set-aside needs. Their expertise in medical case management and compliance services exceeded our expectations. The personalized attention to our specific requirements demonstrated their commitment to excellence.

Outstanding Experience! We have been relying on Capstone for over a year now, and their dedication to delivering high-quality Medicare set-asides and workers' compensation consulting is truly commendable. The team's extensive knowledge, coupled with their responsive customer service, has made a significant impact on our operations. Their compliance services are thorough, and their commitment to excellence shines through every interaction.

Professionalism at its Best! Working with Capstone has been a game-changer for our organization. Their expertise in medical cost projections, liability Medicare set-asides, and case management support has streamlined our processes. The team's attention to detail, combined with their seamless CMS registration and submission services, has provided us with peace of mind. Trustworthy, efficient, and highly recommended!

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Information

Call Us For Query

770-898-4148