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MEDICARE SET ASIDES

Why Conditional Payments Matter

The federal Medicare program has a legal right to be reimbursed for medical payments it makes before a liability, no-fault, or worker’s compensation claim is closed or settled.

Section 111 mandatory insurance reporting provides Medicare with detailed information about claims that involve Medicare beneficiaries. With that information, Medicare’s recovery contractors actively pursue reimbursements for those reported claims.

If these reimbursement payments are not made in a timely manner, Medicare can refer the debt to the Department of Treasure who to charge interest and levy or litigate against all relevant parties.

This matters to Medicare because the money at stake is significant.

Why to Use a Vendor to Manage Conditional Payments

Managing conditional payment reimbursement can be quite complex. Each step must be handled following exact policies and procedures from Medicare. These policies and procedures are constantly changing. This can become quite frustrating for adjusters and attorneys to manage on their own.

What CP Resolutions Will Do for You

CP Resolutions manages the entire Conditional Payment process for you, so you can focus on what you do best.

Our team of claim, medical and legal experts will determine – as quickly as possible – what is owed to Medicare. We will ensure that the demand from Medicare is the lowest it can be, to minimize the cost to you and to make settlement happen more quickly and smoothly.

Specifically, CP Resolutions will:

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Notify Medicare of the existence of the claim and verify that the claimant is indeed a Medicare beneficiary
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Monitor and communicate any updates the conditional payment amount
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Obtain the initial Conditional Payment Letter
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Obtain the final demand amount
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Dispute charges to minimize the conditional payment amount
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Assist in paying the final demand correctly
CP Resolutions also provides detailed monthly reports regarding Medicare compliance.

We are also able to integrate the conditional payment management process within your existing claim system and standard operating procedures.

For More Information about Conditional Payment Management: Call Us at 855-571-4151