Medicare Secondary Payer recovery portal’s additional functionality

by | May 15, 2019

August 20, 2018 
by James Martinez

On August 16, 2018, the Centers for Medicare and Medicaid Services (CMS) held a town hall webinar discussing new and forthcoming functionality of the Medicare Secondary Payer Recovery Portal (MSPRP). This is welcome news to those who deal with Medicare conditional payments daily and shows continuing efforts by CMS to make coordination of benefits and traditional Medicare recovery efforts a one stop self-service for all.

The Medicare Secondary Payer Recovery Portal (MSPRP) is a web-based tool designed to assist in the resolution of liability insurance, no-fault insurance, and workers’ compensation Medicare recovery cases. The MSPRP provides the ability to access and update certain case-specific information online. CMS emphasized benefits of utilizing multi-factor authentication (MFA) to view unmasked and more complete claim details shown on the MSPRP.

Some of the current portal capabilities and developments noted recently in the July 2018 updated MSPRP User Guide include the ability to:

  • See current conditional payment amounts
  • View case information, claim type, case ID number, refund status
  • See correspondence that has been sent and received
  • Request a copy of the Conditional Payment Letter
  • Provide insurer debtors and their authorized recovery agents the option to download electronic conditional payment letters
  • View and dispute pre-demand claims
  • Initiate an initial determination/demand
  • View the decision status of claims
  • Submit appeal requests for redetermination

Here are just some of the upcoming developments anticipated in the future for the portal:

  • Ability to report and establish new workers’ comp, no-fault and liability cases is expected in early 2019
  • Ability to make recovery payments.

The MSP recovery industry and Optum Settlement Solutions, thanks CMS for hearing our suggestions and continuing to modify the portal to make MSP compliance more automated and expeditious. If you have questions or need technical help concerning the MSPRP options accessible, call their help desk at 1-855-798-2627, rather than the BCRC and CRC.

As always, Optum Settlement Solutions stands ready to assist any of our current or potential clients with any conditional payment issue, including any questions or concerns pertaining to the latest announcements made by CMS on the MSPRP additional functionalities.

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