MEDICARE FINAL CONDITIONAL PAYMENT PROCESS

Medicare has a process that allows for an expedited resolution of a Final Demand.

If you anticipate settlement within 120 days of your client's case, we can initiate this expedited process, allowing you to download a Final Conditional Payment Letter pre-settlement. This will enable you to get a final number pre-mediation, which Medicare will honor for 3 days. In the event that dates change and the case does not settle, there will be no negative impact; instead, it will just kick you out of the expedited process. This process can only be done one time for the life of the case.

If you are within 120 days of settlement, we recommend that you enroll your case in this process to give your client an accurate net amount before settlement.

A more in depth explanation of the process can be found using Medicare's PDF document, which you can access at this link.

https://www.cms.gov/medicare/coordination-of-benefits-and-recovery/coordination-of-benefits-and-recovery-overview/msprp/downloads/final-conditional-payment-process.pdf

If you would like us to take advantage of this new process on your behalf, please call us at 407-232-7676 to provide us advance notice of your mediation dates.