CMS Provides High Level Overview of MSPRP and Insight into Future Enhancements

CMS, Conditional Payments, MSP News on August 17, 2018
Posted by Jean S. Goldstein, JD, CMSP

Yesterday, the Centers for Medicare & Medicaid Services (CMS), held an informative webinar to address the benefits of using the Medicare Secondary Payer Recovery Portal (MSPRP), a web-based application for managing Medicare recovery cases (or conditional payments).  The webinar was an overview explaining the various benefits of using the MSPRP, how to get started using the portal, and basic functions and resources available to assist in managing Medicare recovery cases. CMS also indicated they have been working to refine and add more functionality to the portal.  As it stands today, you can use the MSPRP to:

  • View case information;
  • View current conditional payment amounts;
  • Request a copy of the Conditional Payment Letter;
  • View and dispute claims (pre-demand);
  • Initiate the demand process; and
  • View claims and submit redetermination or appeal request.

Recall that CMS recently released an updated MSPRP user guide, based on new portal features, which were implemented in an effort to create more efficient practices for the recovery process.  The updated user guide, along with CMS’ webinar, outlined the recent enhancements to the portal.  Specifically, as of July 2018, the MSPRP now shows the status of incoming/outcoming correspondence in the “new letter” activity tab.   You can also now request electronic Conditional Payment Letters in the MSPRP.  The benefits of using the portal are further enhanced when using Multi-Factor Authentication (MFA), which allows a user to view complete claims detail on any claims listing page, including type of service on claims, the processing contractor, provider name, diagnosis codes, DRG Cd, CPT/HCPCS, and service dates.  You may recall, CMS first introduced MFA in 2015.  For more information about MFA, see our 2015 blog, here.

Perhaps the most exciting news, is the news of future enhancements coming to the MSPRP.  CMS announced that in the future, the MSPRP will be able to be used to:

  • Report a liability, auto/no-fault, or workers’ compensation case on the MSPRP; and
  • Submit payments for recovery cases on the MSPRP.

It appears that CMS is attempting to get a handle on some of the current challenges associated with the conditional payment recovery process.  We will continue to keep our readers updated on the portal’s functionality and CMS’ continued efforts to improve the Medicare recovery process.