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.
Electronic Conditional Payment Letter for BeneficiariesA new feature has been added to the Medicare Secondary Payer Recovery Portal (MSPRP). Beneficiaries are now able to generate an electronic Conditional Payment Letter (CPL) and to print or save it in .PDF format. The electronic CPL will display the current Conditional Payment Amount and associated case and claims information. For further details regarding this new feature, please refer to Chapter 1 of the MSPRP User Manual available under the Reference Material link on the Welcome page of the MSPRP. Enter the following URL to access the MSPRP, https://www.cob.cms.hhs.gov/MSPRP/login. Read and accept the Login Warning to view the MSPRP Welcome page.
Interest Calculation Estimator Tool UpdatedThe Interest Calculation Estimator Tool found in the Attorney, Beneficiary and Insurer Tool Kits has been updated. Please remember, the Tool is to be used for informational purposes only, and may generate an estimate that differs slightly from the actual interest accrued.
Website Consolidation UpdateInformation and resources found on MSPRC.info have been transferred to the Coordination of Benefits & Recovery section on the Medicare tab of the CMS.Gov Web Site. The new Coordination of Benefits & Recovery section contains all of the information that currently resides on MSPRC.info as well as information on many other related topics. Please visit the Coordination of Benefits & Recovery section of CMS.gov to see the new web pages. To access the Web Site, go to www.cms.gov and click on the Medicare tab near the top of the page. Once the Medicare page loads, scroll down to the Coordination of Benefits & Recovery section and select any of the links available.
To access the Group Health Plan Recovery Toolkit go to the Coordination of Benefits & Recovery Overview page at this URL: http://go.cms.gov/cobro and select the Group Health Plan Recovery tab on the left pane.
To access the Liability Insurance, No-Fault Insurance, and Workers' Compensation Recovery Toolkit go to the Coordination of Benefits & Recovery Overview page at this URL: http://go.cms.gov/cobro and select the Non-Group Health Plan Recovery tab on the left pane.
Website ConsolidationThe next step in the restructuring of Medicare's Coordination of Benefits (COB) and Medicare Secondary Payer (MSP) recovery activities is the consolidation of all COB and MSP recovery information and resources into a single comprehensive website. Information and resources found on MSPRC.info will be transferred to the CMS.gov website. It is anticipated that the new consolidated website will be available on or about June 1, 2013. Please continue to monitor this website for further updates.
Commercial Repayment Center (CRC) Contact Information
Effective May 13, 2013, all Group Health Plan (GHP) recovery related refund checks, correspondence, and telephone inquiries should be directed to Medicare's Commercial Repayment Center (CRC).
- By Mail:
- Medicare Commercial Repayment Center
- PO BOX 93945
- 2400 Orange Ave.
- Cleveland, OH 44101-9003
Group Health Plan Recovery Transition
The Centers for Medicare & Medicaid Services (CMS) is restructuring its Coordination of Benefits (COB) and Medicare Secondary Payer recovery activities.This action will provide:
- Improved customer service for stakeholders
- Consolidated and streamlined data collection and recovery operations
- Value-added efficiencies and enhanced resource utilization
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.The MSPRP will allow users the ability to electronically perform the following activities:
- 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.