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Clearing Claims: Medicare Liens Often More Painful Than the Injury

By William Peacock, Esq. | Last updated on

If you've ever tried to get money from the government, you know how painful and fruitless the process can be. Preventing them from taking your client's money through a Medicare lien claim is equally as arduous, pitting your resilience and paperwork skills against an inefficient mess of a system that is uncommunicative, slow, and drowning in acronyms (COBC, MSPRC, HICN, etc.).

To make matters worse, delays in clearing Medicare liens can be caused by anything from forgetting to file a form (your fault) to using a highlighter to point out duplicate or erroneous charges (their insanity). Whether the delay is their fault or yours, it's your client who is harmed and who will be calling you daily, nagging you over their missing funds.

FindLaw's Anne O'Donnell has been there, and wants to help you avoid Medicare lien delays. Here are some tips from her free Practice Guide on Dealing with Medicare Liens in Personal Injury Cases:

Prep the Client and the Case.

In your initial meeting with the client, you'll have to set their expectations low. Though lightning does sometimes strike (in those rare cases when Medicare moves relatively quickly), in nearly all cases, information and action moves like molasses in January, as my dear mother likes to say.

One thing you can do to minimize delays is to ensure that you, and Medicare, have all of the information that you need. Copy both sides of the client's Medicare card. Get copies of any correspondence from Medicare, including bills, statements, letters, etc. The more you have, the less you'll have to ask the client for, and wait for, later.

Start Now.

O'Donnell refers to the Coordination of Benefits Contractor for Medicare as a "black hole" for a reason. With the inherent delays in the COBC, it behooves you to send in your information (a full checklist, and links, are in the Practice Guide) now, not a week or two from now.

Slavishly Adhere to the Instructions.

Like all bureaucracies, there are instructions and procedures for everything. For example, after your initial filing, you'll receive a Rights and Responsibilities letter from the Medicare Secondary Payor Recovery Center (MSPRC). That letter includes a cover letter that you'll need to use in all future correspondence. Failure to do so will likely relegate your letters to the trash can.

Other Tips.

Did you know that in the system used to transfer documents in the Medicare COBC, highlighting disappears? Use a pen instead when itemizing or contesting payments or charges. It's the important, undisclosed and unwritten tips like these that you only learn in practice (or from our Practice Guides) that can save the day from lien delays.

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