Duplicate Medicare Records Established

September 16, 2020

It is not uncommon for duplicate records (same date of loss, injuries, etc.) to be established with Medicare. A Responsible Reporting Entity (the party that is responsible for funding a claims payment to an individual eligible for Medicare benefits) is obligated to report a record under the Medicare, Medicaid and SCHIP Extension Act (MMSEA) of 2007. Simultaneously, the plaintiff's attorney of record has a duty to report the case, which also creates a record with Medicare.

As one might expect, this dual reporting leaves open the opportunity that the information reported on both sides does not match up perfectly resulting in duplicate records being established. Duplicate records can be closed by notifying Medicare that the duplicate records are in fact from the same settlement. Medicare is mindful that duplicate records are common and generally receptive to closing them down. Unfortunately, not all parties will be copied on every record that is established. This makes it increasingly important to educate and instruct your clients to provide you with any correspondence received from Medicare as they will always receive a copy of all Medicare correspondence. This will help avoid the situation of Medicare escalating the duplicate debt and save you and your clients from the time-consuming pursuit of shutting down a record in its later stages.

About Carol

Providing you with Medicare Lien Resolution Tips

Carol is a tenured subject matter expert in Medicare lien resolution with extensive experience in client onboarding and implementation, client relationship management, and case management. Her case management skills range from the intake phase to representing clients at the Administrative Law Judge level. Her background includes opening and managing a satellite office for one of the leading legal service companies. Carol has managed teams that adjudicated asbestos exposure, drug ingestion, and personal injury claims. Carol is dedicated to helping her clients and their claimants successfully navigate each step of the complex Medicare process, from injury to a comprehensive case resolution. With over 20 years of experience, and a passion for customer service, Carol facilitates comprehensive case management for her clients at LitPRO LLC.

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