Medicare liens may be old hat to you if you’ve been practicing law for any length of time. If you’re newer to the idea, here’s a quick rundown. If a client uses Medicare (or Medicaid) as their medical insurance coverage, and that client receives a settlement relating to an injury, the federal or state government is obligated to recover conditional payments made in relation to treatment for said injury. This recovery effort results in Medicare or Medicaid issuing a lien toward the settlement. Similar liens may also be issued by private insurers, but we’ll focus on Medicare today.
Working with Medicare authorities can get complicated, especially if you determine your client has reason to appeal the lien or request Medicare waive recovery of conditional payments—usually based on financial hardship or an error in the conditional payments. The length of time necessary to resolve these liens varies widely, but with the right strategy and the right support services, you can ensure Medicare liens don’t eat up too much of your time.
Clients and Communication
Obviously, the first step in determining whether a settlement will be subject to a Medicare lien is to determine your client’s Medicare status. Individuals are eligible for Medicare based on age, disability, or a diagnosis with end-stage renal disease, so the Medicare question should be standard for new clients. If the client does receive Medicare benefits, then you should report the case to Medicare as early as possible to get the ball rolling.
Equally important is to communicate early and often with the client about the possibility of a Medicare lien against their settlement. Clients don’t like surprises, and it’s possible—even probable—Medicare will issue a lien against all medical treatment they cover while the case or claim is active, whether that treatment is related to the case or not. Clients need to be prepared, to know how their settlement is likely to be disbursed, and they need to clearly understand that the lien only applies to treatment administered in relation to the injuries.
Medicare’s Benefits Coordination and Recovery Center (BCRC) has a bit of a reputation for slow-moving and complicated processes. The introduction of an online portal for filing claims, appeals, and payments has streamlined this process somewhat, but the process can still be time-consuming and complicated depending on your level of experience with the policies and procedures. And, of course, everything requires diligent follow-up.
The good news is your time doesn’t have to be consumed in this process because you have access to a team of experts at The Records Company. We handle the details and follow-ups at each step of the Medicare lien process, start to finish. Your only step is to submit the lien request to us through our secure portal. We do the rest.
After we receive a lien request we submit it to Medicare. Our account in their portal keeps us updated once the case is created. If Medicare is unaware of a pending settlement, we notify them on the attorney’s behalf. Then we follow up with the conditional lien and final lien.
Because we also specialize in retrieving medical and billing records, we can review the lien’s itemized statement to verify related claims. If unrelated claims do appear on the lien, we can submit the appeal and supporting medical and billing records for review. Once a lien is complete and disputes are resolved, we submit the settlement information from the attorney to Medicare and they issue the final lien for us to provide to the attorney and client for payment.
Based on this summary, it’s easy to see how the Medicare recovery process can quickly become time-consuming, but our services mean it isn’t your time being consumed. Because we know the ropes so well, we can move through the many steps of the process quickly and get your clients’ liens resolved, so they can receive their settlements and move forward with their lives. Contact us to learn more about how our expertise translates to peace of mind for you and your clients.