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Reporting a Case to the Benefits Coordination &Recovery Center (BCRC)In Liability Insurance, No-Fault Insurance & Workers’Compensation Cases1

OverviewThis Document Includes the Following: Roles & Responsibilities of the Benefits Coordination &Recovery Center (BCRC) Instructions for Reporting a Case to the BCRC Methods of Contacting the BCRC Rights and Responsibilities Letter Conditional Payment Letter2

BCRC Roles & ResponsibilitiesIn Liability Insurance (Including Self-Insurance), No-FaultInsurance & Workers’ Compensation Cases: The BCRC collects information from multiple sources toresearch Medicare Secondary Payer (MSP) situations, asappropriate. (e.g., They collect the information fromclaims processors, MMSEA Section 111 MandatoryInsurer Reporting submissions, workers’ compensationentities) The BCRC is responsible for updates to MSP situations,including insurance updates, address changes, changesin coverage effective dates, etc.3

Reporting a Case to the BCRC Always contact the BCRC first whenever you have a pendingliability, no-fault, or workers’ compensation claim. Be preparedto provide the following information: Beneficiary Information- Full Name- Medicare Number- Gender and Date of Birth- Complete address and Phone number Case Information- Date of injury/accident, date of first exposure, ingestionor, implant- Description of alleged injury or illness or harm4

Reporting a Case to the BCRC cont. Case Information (continued)- Type of Claim (liability insurance, no-fault insurance,workers’ compensation)- Insurer/workers’ compensation entity name and address Representative Information- Attorney or other representative name- Law firm name if representative is an attorney- Complete address and phone number5

Contacting the BCRCBy TelephoneBCRC Call Center:1-855-798-26271-855-797-2627 (TTY/TDD)Hours of Operation: Monday – Friday, 8 a.m. – 8 p.m. (ET)By Mail – General InquiriesMEDICARE – MSP General CorrespondenceP.O. Box 138897Oklahoma City, OK 73113-88976

Rights and Responsibilities Letter Once the case is established with the BCRC, you willreceive a “Rights and Responsibilities” Letter (RAR).Note: If Medicare is pursuing recovery directly from theinsurer/workers’ compensation entity, the beneficiary andbeneficiary’s attorney or other representative will receive acopy of recovery correspondence that is sent to theinsurer/workers’ compensation entity. The RAR letter is mailed to all parties associated with the caseand is accompanied by:– A correspondence coversheet,– An educational brochure, and– A Privacy Act enclosure7

Conditional Payment Letter A “Conditional Payment Letter” or “CPL” providesinformation on items or services the BCRC has identifiedas being related to the pending Non-Group Health Plan(NGHP) claim. The conditional payment amount is aninterim amount. Medicare may continue to makeconditional payments while a matter is pending. An initial CPL does NOT need to be requested. A CPL willbe generated automatically within 65 days of theissuance of the "Rights and Responsibilities" Letter.8

Conditional Payment Letter(continued) Review the CPL thoroughly to make sure that onlycase related claims are included. Beneficiaries can obtain up–to-date conditional paymentamounts by accessing the My Medicare.Gov website. Afterlogging in, select the MSP tab and then click the Case ID orGo to MSPRP button.9

Conditional Payment Letter(continued) Attorneys can obtain conditional payment informationfrom the Medicare Secondary Payer Recovery Portal(MSPRP) using this link:https://www.cob.cms.hhs.gov/MSPRP.- Registration must occur before access to the MSPRPis permitted.- Authorized MSPRP users may request access to viewunmasked claims data that was previously onlyaccessible to the beneficiary. Individuals requestingthis access must complete the Identity Proofing andMulti-Factor Authentication process on the MSPRP.10

Conditional Payment Letter A “Conditional Payment Letter” or “CPL” provides information on items or services the BCRC has identified as being related to the pending Non-Group Health Plan (NGHP) claim. The conditional payment amount is an interim amount. Medicare may continue to make conditional payments while a matter is pending.

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