Conditional Payments

Now Available – CMS Electronic Payment Enhancement Overview

CMS has now posted the Electronic Payment Enhancement Overview Webinar presentations which were held on March 13, 2019, for NGHP and March 14, 2019, for GHP.  The presentations can be found in the Downloads section of the Coordination of Benefits & Recovery Overview What’s New page on CMS.gov.

CMS Hosts MSPRP Electronic Payment Enhancement Webinar

The March 13, 2019 webinar offered by CMS provided a description of the new direct payment features available through the Medicare Secondary Payer Recovery Portal (MSPRP) as of April 1, 2019.  CMS will be releasing presentation slides within five (5) to seven (7) days and will also be releasing the audio recording thereafter.  Some of […]

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 […]

doctor passing a paper to a hand

Medicare Open Enrollment and its Potential Impact on Conditional Lien Recovery

The Medicare Open Enrollment Period or Annual Election Period runs each year from October 15 to December 7. During this period, Medicare enrollees can make changes to their current Medicare plan to best suit their needs for the upcoming year.  Medicare beneficiaries can: elect to enroll in a new Medicare Advantage Plan (MAP); switch to […]

Medicare Secondary Payer Best Practices PRIMA Podcast with Patrick Czuprynski

Hear the Full PRIMA Podcast Here The Medicare Secondary Payer (MSP) Act has expanded the scope of workers’ compensation and liability claims beyond each individual state’s law concerning Medicare compliance. It also extends responsibility to plaintiffs’ attorneys, claimants of state, as well as self-insureds. As a result, it is vital to realize who is making […]

Despite more function on the Medicare Secondary Payer Recovery Portal (MSPRP), Commercial Repayment Center (CRC) continues to have issues

Recently, Medicare provided a webinar that touted increased functionality of the MSPRP.  These additional functions may allow a party to request an “electronic” conditional payment letter (estimate), prior to an initial determination, but also will provide a view that shows the statuses of correspondences received and sent by Medicare associated with the case number.  This […]

Updates to Medicare Secondary Payer Recovery Portal

The Medicare Secondary Payer Recovery Portal (MSPRP) is a tool developed by CMS several years ago to allow for online access to their recovery processes.   On Thursday August 16th, CMS hosted a Medicare Secondary Payer Recovery Portal (MSPRP) Overview Webinar to discuss some recent enhancements to the system. To reduce the number of calls that […]

CMS Hosts Webinar on Medicare Secondary Payer Recovery Portal

On 8/16/2018 at 1:00 PM EDT, the Centers for Medicare and Medicaid Services (CMS) will be presenting an “Overview Webinar” on its Medicare Secondary Payer Recovery Portal (MSPRP). The MSPRP is a useful tool in assisting parties regarding the Benefits Coordination and Recovery Center (BCRC) and Commercial Repayment Center (CRC)’s collection of conditional payments. Click […]

Effective Conditional Payment Negotiations Webinar – Join us on Wednesday, August 1st

Conditional payment collections can occur under various circumstances in non-group health plan claims and can leave parties bewildered regarding how and when an appeal can be filed. The audience will be provided with outline of appeal process and time frames, effective defenses and case studies of successful conditional payment negotiations with Medicare. Register here to join us on […]

NuQuest’s 98 Percent Success Rate for Conditional Payment Negotiations in 2017

In 2017, NuQuest received 1,933 conditional payment negotiation responses. 1,892 of these responses resulted in a reduction of Medicare’s reimbursement amount. This means NuQuest limited Medicare’s conditional payment reimbursement amount 98% of the time in 2017. There are two entities initiating the recovery of conditional payments paid under Medicare Part A and B: Benefits Coordination […]