| Question |
| If I'm an attorney, what information do I need to have available before I call? |
| What information is needed when contacting Coordination of Benefits Contractor (COBC)? |
| What happens if Medicare pays my accident claims and I also receive money from another insurer? |
| I have a check made out to Medicare, my client and our law firm. How do I handle this? |
| Do I have to turn my medical bills into my auto insurance company? If I do, they will raise rates. |
| What is a Conditional Payment? |
| What if the conditional payment amount includes services that are not related to the incident? |
| Why does Medicare make primary payment on claim when it is likely that another plan is the primary payer? |
| When will Medicare make a conditional primary payment? |
| If a case is settled and Medicare failed to notify the attorney/beneficiary about claims Medicare paid can Medicare still collect reimbursement? |
| Who can Medicare recover payments from? |
| Does Medicare always reduce its recovery by one-third? |
| I have asked the hospital to send their bill to Medicare so it can be paid. They say they do not bill Medicare, is this correct? |
| Since my client only recovered 10% of the value of his claim, will Medicare reduce its recovery to 10% of what it paid? |
| I was in an accident and want to repay Medicare, what do I do? |
| Whom should the attorney contact to notify Medicare of a reimbursement situation? |
| Do I need to notify Medicare if Medicare has paid for my accident-related claims and I have other insurance? |
| Who is responsible for paying my claims if I am injured at someone else’s home? |
| Who is responsible for paying my claims if I am injured at work? |
| How is Medicare made aware of liability, no-fault, workers compensation situations? |
| What is considered to be No-Fault Insurance? |
| What information does the Centers for Medicare and Medicaid Services (CMS) need in order to review a Workers’ Compensation Medicare Set Aside proposal? |
| Does Medicare recover even if the treatment received was related to a pre-existing condition? |
| Does Medicare require a set-aside agreement for a liability case? |
| What role does the provider play in obtaining accident information from a Medicare patient? |
| Is the provider required to bill no fault insurance? |
| Can participating providers of service file a claim against the liability proceeds and not bill Medicare? |
| In a liability case involving several Medicare contractors, which contractor should the attorney specifically deal with? |
| Will Medicare pursue recovery from the estate of a deceased beneficiary? |
| Following a third party liability settlement, award, judgment, or recovery, when can Medicare begin to assess interest on the unpaid balance of Medicare's recovery amount? |
| If a waiver is requested, can the recovery amount owed to Medicare be held in escrow until a decision is made? |
| For waiver consideration, what is meant by "the beneficiary is without fault in causing the overpayment”? |
| For waiver consideration, what is meant by “financial hardship”? |
| With respect to waiver criteria, what is meant by "against equity and good conscience"? |
| Can a partial waiver determination be appealed? |
| Why is a signed Authorization Release Form required before a Medicare contractor can release information to an attorney representing a Medicare beneficiary? |
| When is the appropriate time for the attorney to request a waiver of recovery from Medicare? |
| If the settlement amount is less than what is owed to Medicare, how much will Medicare attempt to recover? |
| What if a beneficiary disregards his/her obligation to repay Medicare after the proceeds of a settlement have been disbursed to him/her? |
| What if the settlement proceeds were disbursed before Medicare became aware of a reimbursement situation? |
| Does Medicare recover even if the payment made is only a nuisance payment? |
| Who is responsible for a bill never submitted to Medicare? |
| Once a settlement has been reached, what information is the attorney required to send to the MSPRC? |
| Does Medicare share proportionately in the costs associated with medical payments benefits? |
| When should an attorney send payment to the Medicare Secondary Payer Contractor for the amount due? |
| Can the conditional payment amount change? |
| Can Medicare waive its right to recover an overpayment from the beneficiary? |
| Is the beneficiary's personal automobile insurance primary to Medicare? |
| What is No-Fault Insurance? |
| In a liability situation, when is it determined that the liability insurer is the primary payer? |
| Under what circumstances can Medicare grant waiver of recovery of an overpayment? |
| If a waiver is denied, can the denial be appealed? |
Sign-up for MSPRC E-Newsletter & View Past Newsletters