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

"I recently engaged Synergy to assist with a complicated PTD settlement involving a substantial Medicare Set Aside. The claimant’s wife has been providing full time attendant care which is not Medicare covered. The Synergy nurse was able to do a full analysis of non-Medicare covered expenses which far exceeded the value of the MSA analysis performed by the carrier’s contracted MSA provider. The non- Medicare figures became the main focus of the settlement negotiations and more than doubled the value of the case. Although I could estimate the attendant care figures, the nurse added in other items that I would not have routinely considered. I also asked Synergy to evaluate the EC’s MSA as well as their prescription review. Synergy offered insight about the prescription donut hole which I did not have a clear understanding about. Again, their insight and information added a great deal of value to the overall settlement. Not only did I learn from Synergy but was able to educate my clients in the process. These are very complex and complicated areas; I will use Synergy again and again!"

Rosemary Eure
Lancaster & Eure

When we face difficult post resolution issues, we turn to Synergy. They provide us with the necessary expert advice about Medicare compliance, preservation of public benefits, lien resolution and settlement planning. We don’t need to go anywhere else, they are the experts when it comes to the case after the case. All of those sticky issues, they easily navigate and let us focus on other issues.

Andrew Knopf
Knopf Bigger

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