Minor changes in newly released Medicare Secondary Payer Recovery Portal User Guide

By Kate Riordan July 12, 2018

The Centers for Medicare and Medicaid Services (CMS) has released an updated version of its Medicare Secondary Payer Recovery Portal (MSPRP) User Guide (Version 4.2). The changes are minor and primarily aimed at streamlining the communication process when requesting conditional payment information.

CMS outlines the main objectives behind these new updates as follows:

  • Reducing the number of calls received by the Benefits Coordination & Recovery Center (BCRC) regarding the status of case correspondence. There is a new read-only Letter Activity tab to the Case Information page which displays correspondence that has been sent related to a Benefits Coordination & Recovery Center (BCRC) or Commercial Repayment Center (CRC) case. (Section 13.1.1)
  • Making the MSPRP more consistent so that both insurers and beneficiaries (and their representatives) can request electronic letters. The MSPRP now allows insurers, recovery agents on the Tax Identification Number (TIN) reference file, and insurer representatives with a verified Recovery Agent Authorization, who also log in using multi-factor authentication, to request electronic conditional payment letters (eCPLs) for BCRC and CRC insurer-debtor cases (Sections 13.1.5 and 14.5.4). It is also noted that eCPLs may also be requested on cases that are in bankruptcy proceedings.
  • Assisting Account Managers (AMs) to determine which currently active designees should be deleted because of long inactivity on an account. A Last Login Date column has also been added to the Designee Listing page. (Section 8.3.2)
  • Listing the Primary Diagnosis Code on the Payment Summary Form (PSF) in cases where Part A, non-inpatient, claims do not have a HCPCS or DRG code associated with them. The Primary Diagnosis Code will appear in bold font on the PSF under the DX Codes column, along with an explanatory footnote. When the Primary Diagnosis Code is bolded, the HCPCS/DRG column will be blank. (Table 13-8)

These updates are geared towards providing stakeholders with current and consistent conditional payment information via electronic access, which could be helpful to parties when settling claims with Medicare-eligible beneficiaries. For example, the new Letter Activity tab on the Case Information page will display all correspondence that has been received, or letters that have been sent related to a BCRC or CRC case in one place and in date order, thereby better enabling the viewer to follow the progress of the case. It is well known that the process for requesting, negotiating and satisfying Medicare’s conditional payments can be tedious and convoluted, which often stalls settlements. The limited changes this new guide provides will hopefully assist parties with obtaining current case-specific information related to the status of a Medicare recovery claim. ISO Claims Partners will monitor the impact of these minor changes and will provide further updates, if warranted.


Kate Riordan

Kate Riordan is the director of Medicare Secondary Payer (MSP) initiatives at ISO Claims Partners. She has well over five years of experience in completing Medicare Set-Asides and obtaining CMS approvals, with a concentration in California claims. Kate graduated Bowdoin College and Suffolk University Law School and is a Medicare Set-Aside Certified Consultant.