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Need Help? Ask!

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7 comments on “Need Help? Ask!

  1. Is there a reqiurement that Medicare be named as an additional payee on a settlement draft from a third party carrier? Can you please provide me with the authority for your answer.

  2. Received final demand from MSPRC. Ltr said I had 180 days “from the date I received the letter”. Long story short, MAXIMUS is now using 180 from DATE OF the letter to say appeal untimely, which it would be if you use the DATE of the letter. I’m not sure exactly when i RECIEVED the letter, but how can they proved WHEN I recieved the letter.

    Any guidance or codes on this specific issue. Can’t seem to find any.

    • Matt,

      On some MSPRC letters it states that the MSPRC assumes you have received a letter five days from its send date. Unfortunately, I’ve seen that on some letters, but not others. If you are close to the 180 days perhaps you can retry with a cover letter stating you were within X days of the letter and that you did not receive it on the day it was sent. Also highlight the fact that the letter gives you 180 days from receipt, and not from its send date.

      If that attempt is also noted as untimely you can try the hearing in front of an ALJ; however, that may be untimely due to the untimely attempts with Maximus. This is not an ideal situation – I suggest you keep pushing though.

      Ryan J. Weiner
      Co-Founder Lien Resolution Services
      http://www.lienresolutionusa.com
      https://lienblog.wordpress.com
      rweiner@lienresolutionusa.com

      This Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.

      • Thanks Ryan. Letter does not have language about “assuming it’s received within 5 days of date of the letter.”

        I’ve sent a request to vacate to Maximus and i’m asking an ALJ to look at it and reverse. Just wanted to make sure i wasn’t missing a specific code or regulation on this issue.

        Ps. MSPRC has a history in this matter of letters not matching up with my address, post marks and late-sendings. Best exampale is one letter with a date of Oct 20,2009 on it. Post mark on envelope was December 9, 2009 and i received it on December 12, 2009. Letter and envelope have two different addresses. I pointed these issues (along with others) out to MAXIMUS and ALJ.

  3. I have been waiting over 80 days for a response from MSPRC to settle up with Medicare for bills that were paid by Medicare. We need to reimburse Medicare.

    • Mr. Crabtree,

      Unfortunately, 80 days to us, does not mean 80 days to Medicare. If you are waiting for a conditional payment letter, the MSPRC quotes 65 days before you will receive it. That 65 days is not 65 days though. First, you must wait 2-10 days for the COBC to transfer your file to the MSPRC. Then, it usually takes another 10-15 days before the MSPRC sends its Rights and Responsibilities (“RAR”) letter. The RAR letter signifies the beginning of your 65 day wait, even if it is already three and a half weeks since you reported the case to Medicare.

      For final liens, the wait is even harder to quantify. If after 30 days your final lien has not arrived, you can have the file expedited to a supervisor. However, the MSPRC had gotten so far behind in June that expedited files seemed to be taking longer than files you simply ignored and allowed to be processed as normal. We have seen final liens take as long as two and a half months, or as short as 35 days.

      Your best option is to call the MSPRC at 866-677-7220 and simply ask if there is any way to speed up the process. Remember, you cannot legally distribute lawsuit funds until after Medicare has been paid back. Lastly, the MSPRC will often claim a lien that includes items totally unrelated to your case and the underlying injuries. A detailed review and analysis is always recommended.

      Ryan J. Weiner
      Co-Founder Lien Resolution Services
      http://www.lienresolutionusa.com
      https://lienblog.wordpress.com
      rweiner@lienresolutionusa.com

      This Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.

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