MSPRC

HAVE YOU REPORTED YOUR LIABILITY INSURANCE, NO-FAULT INSURANCE, OR WORKERS' COMPENSATION CASE?

The first step in the Medicare Secondary Payer recovery process is reporting your case to the Coordination of Benefits Contractor (COBC).  If you have not reported your case, please click here for COBC reporting instructions and contact information.

Don’t Forget!

Once you establish your case with the COBC, you will receive a "Rights and Responsibilities" (RAR) letter from the MSPRC.  The MSPRC will then automatically generate a "Conditional Payment Letter" (CPL) within 65 days from the date on your RAR letter.  You do NOT need to request the CPL separately.

Get Your Conditional Payment Amount Sooner!

You can now get your Conditional Payment amount even sooner on the Self-Service Information Line! When you call MSPRC and select the Self-Service option, you can automatically get Demand and Conditional Payment amounts as well as the dates those letters were issued without having to speak with a Customer Service Representative. You will also be able to request updated Conditional Payment amounts and copies of Conditional Payment letters without ever having to speak to a customer service representative!

When calling the Self-Service Information Line, all you will need is the Case ID, Medicare number, date of birth, and last name of the beneficiary. All of this information can be found on your Rights and Responsibilities Letter.

Medicare Secondary Payer Recovery Portal (MSPRP) Enhancements

The following enhancements have been made to the MSPRP:

• Proof of Representation and Consent to Release examples and blank templates are available on the Authorization Documentation page
  
  
• The number of Account Designees permitted on a Corporate Account has been increased to 100
  
  
• New Reason Codes have been added to explain why an Authorization submitted via the MSPRP was determined to be invalid
  
  
• The Case Listing page has been revised to provide the ability for Account Designees and Account Managers to filter, sort, and remove case information. Please refer to Chapter 11 of the User Manual.
  
  
• The requirements for uploading a file to the MSPRP have been clarified. You can find the specific requirements in Chapter 12 of the User Manual.
  
  
• The User Manual has been re-organized and in many places, rewritten, for clarity, ease of use, and understanding.
  

The Medicare Secondary Payer Recovery Portal is Live!

A new online Self-Service Tool to help manage your Medicare recovery case.

The Centers for Medicare & Medicaid Services (CMS) has implemented a new web-based tool designed to assist in the resolution of Liability Insurance, No-Fault Insurance, and Workers' Compensation Medicare recovery cases. The new tool is called, The Medicare Secondary Payer Recovery Portal (MSPRP).

The MSPRP gives users (attorneys, insurers, beneficiaries, and TPAs) the ability to access and update certain case specific information online. Activities that currently require written communication or telephone calls to the Medicare Secondary Payer Recovery Contractor will soon be able to be done through the portal.

• Submit Proof of Representation or Consent to Release documentation - Instead of mailing in an authorization, users will be able to upload authorizations through the portal.
  
  
• Request conditional payment information - Requesting an updated conditional payment amount or a copy of a current conditional payment letter will be as simple as clicking a few buttons.
  
  
• Dispute claims included in a conditional payment letter - Users will be able to view the claims listed on the conditional payment letter and dispute unrelated claims online.
  
  
• Submit case settlement information - Users will be able to input settlement information online and upload a copy of the settlement documentation through the portal.