Medicare Claim Resolution Process
1-Verification- Find out if client is receiving government benefits
2-Open case with the Centers for Medicare and Medicaid Services (CMS)
3-Request Conditional Payment Summary from Medicare (MSPRC)
4-Review Conditional Payment Summary
5-Dispute unrelated medical claims
6-Request final demand – original demand less unrelated items less procurement costs
7-Request hardship waiver, if applicable
8-Attorney and/or Lien Resolution Center receives Demand letter. Payment is required to Medicare within 60 days of receipt of Demand letter, even if a waiver has been requested.
Medicaid Claim Resolution Process
1-Verification-Find out if the client is receiving government benefits
2-Determine county office handling the case
3-Identify analyst on the case
4-Dispute unrelated medical claims (if not estate case)
5-Request final demand
6-Request hardship waiver if applicable
7-See if Ahlborn is applicable
To engage The Lien Resolution Group
to resolve Medicare/Medicaid Claims
In order for us to determine the services necessary for each individual case we will need the following information submitted:
1-Completed case intake form
2-Signed releases (CMS/SSA)
3-Copy of the Summons & Complaint
4-Copy of the Bill of Particulars
5-Copy of any correspondence with Medicare/Medicaid
If your claimant’s case has settled we will need a copy of the Settlement Statement itemizing the breakdown of the settlement and a copy of the signed Settlement Agreement & Release.
The total costs involved for us to address Medicare/Medicaid’s claims will be $1,800.00. Please process your check made payable to “The Lien Resolution Group”, and reference the name of the claimant on your check.
If you have any questions regarding Medicare/Medicaid claims please contact Brett Newman at 1-800-888-1743.
Please submit all of the requested information above to:
Brett Newman
The Lien Resolution Group
216 Congers Road, Bldg 2C
New City, New York 10956
or email to bnewman@helpwithliens.com
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