To determine if a medical provider can qualify for MAR funding, the focus must not be on the provider's services or goods, but must always look toward "who the payor is." We should examine the qualities of a payor that qualifies for MAR funding first. Examples of such companies are Aetna, Cigna, United Health, Blue Cross/Blue Shield, GHI Medicare (gov't) and Medicaid (gov't).
What makes these companies appropriate for MAR funding? These insurance companies have: 1) contracts with providers and therefore are directly paid by the carriers
2) pay "out of network" reimbursements to those patients who use providers that are not "in their plan." BUT...in all cases, they carry medical coverage which has virtually limitless patient funding amounts, and are not contingent upon legal outcome or compensation-board approval.
So we ask, is a Chiropractor (for example) able to use MAR funding? The answer is YES...however, that provider can only sell the claims of "traditional" type carriers as exemplified above. Unfortunately, Chiropractors usually have the majority of their payors as workers compensation or personal injury carriers. These cannot be MAR funded as the payment has a contingency on it, and there is no contract, or obligation to pay until such adjudication is reached. Suppose the Chiropractor is predominantly paid by Medicare, then we have a MAR funding opportunity.
The case can be made however, that personal injury carriers are insurance companies, and therefore can be used in MAR funding. Correct, however the contracts under which patients get reimbursements are auto or casualty contracts, and not medical coverage, refuting that theory.
Suppose a provider has both traditional carriers and some workers compensation/ personal injury, will the MAR funding company entertain that kind of provider? Yes! The MAR funding company will purchase only those claims paid by the traditional payors!
To see if you qualify for MAR funding...look to the payor!
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