Synergy Blog

A Timeline for Medicare Lien Resolution with MSPRC

MSPRC Resolution Timeline*

CMS has revamped the Medicare recovery process, creating a more efficient and less questionable path for the verification of Medicare conditional payments. Based on a compilation of facts from www.MSPRC.info, Medicare Correspondence, and daily interaction with MSPRC, we have created a timeline to a serve as a general guide to the Medicare Resolution Process, and what can be expected by all parties entering a settlement with a possible Medicare obligation.

The following is an approximate timeline for the Medicare recovery process*:

  1. Day 1: Report to Coordination of Benefits Contractor (COBC) by calling 1(800)999-1118.
  2. Day 2 – 12: The case is transferred to the Medicare Secondary Payer Contractor (MSPRC) from the COBC within 2 weeks.
  3. Day 14-21: Within (7) days of the record being created in the MSPRC’s database, a Rights and Responsibility (RAR) letter will be sent to the beneficiary and their attorney.
  4. The MSPRC will begin their claim retrieval process, which takes approximately 8 weeks.
  5. Day 30 – 65: Effective October 1, 2009 the MSPRC will issue a conditional payment letter to the beneficiary and all authorized parties reflecting Medicare’s recovery amount within (65) days of the date of the RAR.
  6. An updated conditional payment amount can only be requested every 90 days.
  7. Day 66 – 95: Once all settlement information has been provided to the MSPRC, the demand should be issued within 10 – 30 days.

Synergy can assist in the resolution of Medicare liens. Contact us at info@synergysettlements.com or by calling us at (877)907-5436 for more information on how we can help.

*The estimated turnaround times for Medicare Conditional Payment summaries and Final Demands can vary and may be prolonged due to volume as a result of the newly implemented reporting requirements under MMSEA Section 111. Further instruction on the Medicare Secondary Payer process is found on www.msprc.info.

TESTIMONIALS

"In my twenty-two year career as a trial lawyer I've handled my share of catastrophic cases and structures, but imagine the complexity of an engaged, unwed mother catastrophically injured during delivery, giving birth to a healthy child, but left in a vegetative state? The issues of guardianship and entitlements of the newborn, the rights of the biological father-fiancé, an out-of-state teenage child of the mother, lifetime maintenance of the mother, as well as the rights of family of the mother, who became her primary care-takers? Synergy systematically managed the seven figure tender of one defendant, the establishment of a Qualified Settlement Fund, a Special Needs Trust, and multiple structures, all the while concurrently maintaining the various entitlements to ancillary services, as well as the remaining litigation. Everything was handled professionally, timely and literally without a hitch. Truly an amazing feat."

Marcus J. Michles II
Michles & Booth

"Whenever I have turned to Synergy, their team has always been there for our firm and our clients. They always take the time to answer all our clients’ questions and provide quick, accurate and reliable information so they can make an informed decision regarding structured settlements. With Synergy on our side, we know that our clients are getting the best service and the best structured settlements."

Troy Rafferty
Levin, Papantonio, Thomas, Mitchell, Echsner & Proctor

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