Medicare coordination of benefits and recovery phone number

Description

Helps Medicare beneficiaries with coordination of benefit issues and manages data for certain Medicare claims

Their work includes:
* Researching if Medicare or another plan should pay first
* Recovering payments from beneficiaries made for them by mistake
* Updating databases about employer, no-fault and workers' compensation plans
* Creating Medicare Secondary Payer (MSP) records to keep Medicare from paying when it shouldn't
* Sharing data to the Medicare Beneficiary Database (MBD) for prescription drug benefit coordination

Features

• Specialization
  • Disabilities 
  • Older adults 

Eligibility

When to contact the Center
* To report employment changes or any other insurance coverage information
* To report a liability, auto/no-fault, or workers' compensation case
* To ask a question about:
- General Medicare Secondary Payer (MSP) issues
- MSP letters and questionnaires

Application Instructions

Call for assistance between 8:00am - 8:00pm, Monday - Friday (Eastern Time)

Fees

There is no fee for this service.

Area Served

Websites

Phone Numbers

Last Update

10/13/2022

Other Locations

This provider does not offer this service at other locations.

Taxonomy Terms Used. Clicking a taxonomy term from the list below launches a new search.: Clicking a taxonomy term from the list below launches a new search.

• LH-3500.5000Medicare Information/Counseling Definition

  Programs that offer information and guidance for older adults and people with disabilities regarding their health insurance options with the objective of empowering them to make informed choices. Included is information about benefits covered (and not covered); the payment process; the rights of beneficiaries; the process for eligibility determinations, coverage denials and appeals; consumer safeguards; and options for filling the gap in Medicare coverage (Medigap supplement insurance). Also available is information relating to an individual's eligibility for benefits and assistance with evaluating their options and enrolling in a Medicare plan (A, B, C, and/or D) that will best meet their needs. These programs also address coordination of benefits when beneficiaries have other types of health insurance in addition to Medicare (e.g. Medicaid, employer coverage or retiree insurance) and provide counseling and assistance regarding the subsidies that are available to low income beneficiaries enrolled in the Part D Prescription Drug Benefit (which help pay for Part D premiums and reduce the cost of prescriptions at the pharmacy) and the Medicare Savings Programs which help pay for Medicare out-of-pocket costs. They may also provide information about Medicaid and the linkages between the two programs, referrals to appropriate state and local agencies involved in the Medicaid program, information about other Medicare-related entities (such as peer review organizations, Medicare-approved prescription drug plans, Medicare administrative contractors), and assistance in completing related Medicare insurance forms.

• YC-5100Medicare Beneficiaries Definition

  Individuals, age 65 and older or younger than age 65 with a disability, who have hospital, medical and prescription drug insurance through the federally-funded Medicare program.

• YC-9500Workers Compensation Recipients Definition

  Individuals who have lost their earnings due to accidental injury on the job or occupational illness and are receiving compensation from the government mandated, employer supported disability program.

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Unauthorized or improper use of this system is prohibited and may result in disciplinary action, as well as civil and criminal penalties.

Personal use of social media and networking sites on this system is limited as to not interfere with official work duties and is subject to monitoring.

By using this system, you understand and consent to the following:

*You have no reasonable expectation of privacy regarding any communication or data transiting or stored on this system.

*The Government may monitor, record, and audit your system usage, including usage of personal devices and email systems for official duties or to conduct HHS business. Therefore, you have no reasonable expectation of privacy regarding any communication or data transiting or stored on this system. At any time, and for any lawful Government purpose, the Government may monitor, intercept, and search and seize any communication or data transiting or stored on this system.

*Any communication or data transiting or stored on this system may be disclosed or used for any lawful Government purpose.

The collection of this information is authorized by Section 1862(b) of the Social Security Act (codified at 42 U.S.C 1395y(b)) (see also 42, C.F.R. 411.24). The information collected will be used to identify and recover past conditional and mistaken Medicare primary payments and to prevent Medicare from making mistaken payments in the future for those Medicare Secondary Payer situations that continue to exist. The Privacy Act (5 U.S.C. 552a(b)), as amended, prohibits the disclosure of information maintained by the Centers for Medicare & Medicaid Services (CMS) in a system of records to third parties, unless the beneficiary provides a written request or explicit written consent/authorization for a party to receive such information. Where the beneficiary provides written consent/proof of representation, CMS will permit authorized parties to access requisite information.

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