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Medicare Secondary Payer (MSP) Demand Letters

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​What is an MSP Demand?

The Commercial Repayment Center (CRC) issues a Medicare Secondary Payer (MSP) Demand when Medicare makes primary payments to beneficiaries that it believes should have been made by the group health plan. If that happens, you will receive a letter from the CRC regarding a Medicare Secondary Payer (MSP) debt.

What can we do to help?

Blue Cross of Northeastern Pennsylvania (BCNEPA) will also receive the MSP Demand, including the corresponding claims. We will research the MSP Demand to determine if the group health plan or Medicare is the primary payer. Next, we will review each claim to see if we already paid the provider and compile the benefit and applicable precertification information. Finally, we will either send a letter to the CRC with our rebuttal (with full documentation) on why the debt is not owed, or we'll process the claims to pay the CRC. This research and rebuttal/claims adjudication may take up to 60 days.

Frequently Asked Questions (FAQ)

Question:Does BCNEPA need a copy of what we received from the CRC?
Answer:No. BCNEPA will receive all of the necessary correspondence from the CRC.
Question:Should we issue payment to the CRC to resolve the debt?
Answer:No. BCNEPA must review each charge on the MSP Demand to determine if a payment is necessary. In many cases, the charges were previously submitted to and paid by BCNEPA.
Question:Will we be notified when BCNEPA responds to the CRC?
Answer:Yes. When BCNEPA has completed the processing of an MSP Demand and responds to the CRC, a copy of our correspondence will be sent to the policy maker at your company and your sales professional at BCNEPA.
Question:Will we be charged any interest by the CRC?
Answer:No. BCNEPA makes every effort to avoid interest accrual by responding to each MSP Demand before the due date established by the CRC (60 days). In the event that interest must be paid, it will be paid by BCNEPA and not charged to your company.

If you have questions or concerns about the MSP Demand process, please contact your BCNEPA sales professional.