With a growing volume of Medicare conditional payment activity, increased Department of Treasury involvement, and a federal appeals process full of strict deadlines, it’s no surprise that many insurers find themselves facing Treasury Offsets or situations where payment feels like the only option. Once the money is gone and Medicare closes their file, it can often feel like the end of the road, but it doesn’t have to be. We understand that dealing with the intricacies of Medicare compliance can be a challenge, but we're here to tell you that you're not alone, and Verisk developed a solution - Recovery Reversal - to claw back the Medicare overpayment or offset.
Medicare Conditional Payment Recovery by the Numbers
Medicare’s conditional payment recovery continues to grow. According to the latest Medicare Commercial Repayment Center (CRC) report to Congress, in Fiscal Year 2022 the CRC identified $441.71 million in conditional payments for their Group Health Plan (GHP) and Non-Group Health Plan (GHP) collection workloads and collected a total of $347.10 million, with $84.16 million of that amount collected by the Department of Treasury[1]. Within that, the report notes that 13% ($48.15 million) of the total amount collected by the CRC was ultimately refunded.[2]
In our experience, many conditional payment demands can be challenged. In fact, in 2022 Verisk’s team was able to achieve an average reduction of 82% on demands we were engaged on. However, not all demands are appealed and not all appeals are successful, potentially leading to Medicare collecting in circumstances where the conditional payment could have been appealed. These situations where Medicare receives an overpayment can take many forms - from the dreaded Treasury Offset to situations where an adjuster feels like there are no further avenues to get an appeal reviewed and makes payment simply to stop the bleeding. This is where Recovery Reversal can help.
What is Recovery Reversal?
If you've paid a Medicare conditional payment demand that you firmly believe you didn't owe, or if you've experienced the frustration of a Treasury Offset applied to a claim, our team is here to assist you in getting a refund. For applicable claims, our dedicated team of experts will thoroughly review your Medicare overpayment, from demand through the overpayment. We'll leave no stone unturned to determine if a refund can be obtained, even if your Medicare recovery case is already closed. We understand that the process can be complex and confusing, but we're here to simplify it for you.
Why Choose Recovery Reversal?
- Expertise: Our team consists of professionals who have extensive experience in dealing with Medicare conditional payment and Treasury cases. We know the ins and outs of the system, we know the appeals process, and we'll put that knowledge to work for you.
- Personalized Solutions: We understand that each case is unique, and we treat it as such. Our approach is tailored to your specific situation, ensuring that you get the attention and assistance you need.
- Timely Resolution: We understand the frustration and anxiety that can come with Medicare disputes. Our goal is to resolve your issues as quickly as possible, providing you with peace of mind.
- No Case Left Unexamined: Even if your Medicare case is closed, we won't give up. We'll review your case to determine if a refund is possible.
How to Get Started
Recovering your hard-earned money and taking control of your Medicare conditional payments is just a few steps away:
- Contact Us: Reach out to our team to discuss your Medicare overpayment issue.
- Consultation: We'll provide a thorough consultation to understand your situation and assess the best course of action.
- Review and Resolution: Our experts will review your Medicare case, seeking a refund where possible. If we believe a refund is possible, we’ll start the dispute process and work to get the refund. We'll keep you informed every step of the way.
- Regain Control: With Recovery Reversal on your side, you can regain control over your Medicare payments and enjoy the peace of mind you deserve.
Don't let unjust Medicare demands or Treasury Offsets disrupt your life. Let Verisk be your trusted partner in navigating the complex world of Medicare conditional payments. We're committed to helping you recover what's rightfully yours.
If you have a case where a Treasury Offset was applied or where you made payment to Medicare for treatment you did not believe was ultimately your responsibility, then contact us to determine if Recovery Reversal may be applicable for your case. Together, we'll make sure that you don’t overpay Medicare and work to get you a refund.
[1] “The Medicare Secondary Payer Commercial Repayment Center in Fiscal Year 2022”, https://www.cms.gov/medicare/coordination-benefits-recovery/overview/reports
[2] “The Medicare Secondary Payer Commercial Repayment Center in Fiscal Year 2022”, https://www.cms.gov/medicare/coordination-benefits-recovery/overview/reports
