New CRC Contractor: What Are Our First Impressions?

Conditional Payments, CRC, Medicare Set-Aside Blog, MSP News, WCRC on March 20, 2018
Posted by Jean S. Goldstein, JD, CMSP

It’s been over a month since the anticipated transition of the Commercial Repayment Center (CRC) contractor from CGI Federal to Performant Recovery.  Our first impressions have all been positive.  As with all transitions to new government contractors, we of course had some reservations and concerns, but to date are encountering only positive experiences.

Some quick highlights and positives since the transition:

  • The representatives are eager to help and seem quite knowledgeable in understanding the process;
  • The portal now shows refunds and redeterminations, in separate tabs which expedites the process allowing us to more accurately determine the status of a case;
  • The standard fields on correspondence now include a column for HCPCS/DRG codes, as shown below (click to enlarge), which should assist in determining whether services provided, particularly in an inpatient setting, were actually related to the diagnoses accepted under the WC claim. Hopefully the CRC staff will use these codes as well to better identify the bills for unrelated services currently found within many Conditional Payment Notices, as it will allow them to review any potential payments more accurately and systematically.

We are hopeful we will continue to see positive change with the new CRC.  We anticipate the backlog will be cleared in the near future and hope to soon be able to dispute charges through the portal.  It seems as though a common trend we are seeing with the transition to new contractors is the goal of making each transition as seamless and painless as possible.  On that note, it has also been one day since the new Workers’ Compensation Review Contractor began work.  If you missed the webinar about this transition, the presentation can be downloaded here.  We are eager to continue to work with both of these contractors, and have high hopes we will continue to see positive results.