MSP claims

[Guest BenefitsLawyer]

Is anyone else being deluged with Medicare Secondary Payer claims, referrals to Treasury, offsets, etc.? Has anyone succeeded in getting anyone at CMS, Treasury, or the CMS contractor (MSPRC) to return calls, listen, explain, acknowledge that there are problems?

[Mary C]

Yes. We received 150 new cases in one day - most for under $100. We have also experienced a very large number being turned over to collection agencies while MSPRC is still sending us correspondence. I would say out of 20 or so that have been turned over to collection agencies, only one had not had any payment or defense previously submitted to Medicare. In some instances, we get a closure letter on the same day as the notice from a colleciton agency.

We are also experiencing a tightening of documentation required. MSPRC used to accept an insurer's "claims payment worksheet" showing how they adjudicated claims, but now they are insisting on EOB's. The entire plan document must be submitted to assert a timely filing defense when they used to take just the pertinent pages.

No call backs from messages left, but the answering tape on the MSPRC line is priceless - "if you have received an intent to refer letter, please be assured we will not turn your account over to Treasury until all correspondence has been worked." Is that the same as we're from the government and we're here to help you?