Report The Claim To The Coordinator of Benefits Contractor
The first step in obtaining conditional payments information is informing the Coordinator of Benefits Contractor of the work related injury or personal injury suit giving rise to the medical treatment.
An Initial Conditional Payments Letter No Longer Needs To Be Requested
An initial Conditional Payment Letter (CPL) does NOT need to be requested. A CPL will be generated automatically within 65 days of the issuance of the "Rights and Responsibilities Letter." This allows all available medical claims to be retrieved. Conditional Payment Letters will go to all authorized parties. Additional requests for Conditional Payment Letters will not speed up the process. Normally if a Conditional Payment Letter has been sent, requests for an updated CPL can only be processed every 90 days after last CPL was issued. If settlement will occur within 30 days an updated CPL can be requested. If authorization is not on file with the MSPRC, the beneficiary will receive the letter and their attorney and/or representative must obtain a copy through the beneficiary.
Review The Conditional Payment Letter
Review the Conditional Payment Letter thoroughly to make sure that only case related claims are included.
Provide MSPRC With Final Settlement Documentation
Once case has settled, the settlement documentation must to be sent in to the MSPRC. The MSPRC then generates a final demand letter when they receive the settlement information.
Make Payment In A Timely Manner
Payment to Medicare is due within 60 days of the date of the demand letter. If payment is not received within 60 days of the date of the demand letter, interest will be charged from the date of the demand letter.
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