Conditional Payments in Review: 2018

In February of 2018, we saw a new contractor operating Medicare’s Commercial Repayment Center (CRC), Performant Financial Corporation.  As expected, there were growing pains or learning curves experienced with the new operator, such as: inappropriate referrals to U.S. Treasury for collection, letters of authorization inappropriately denied, statement of reimbursement forms not matching decision letters and ongoing grouper errors.

Despite these issues, we continue to see Medicare consistently seek reimbursement for payments that do not require reimbursement under the Medicare Secondary Payer Act. This is regardless of whether CRC is collecting based upon Ongoing Responsibility of Medical Reporting or the Benefits Coordinator and Recovery Center (BCRC) collecting based upon settlement reporting.

Specifically, in 2018, NuQuest had an impact rate of 95.2%. This means 95 out of 100 negotiations resulted in savings to our customers.

These savings totaled over $15.2 million dollars.

We will continue to monitor Medicare’s collection process and post updates in the near future.

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