Conditional Payment Claim Leads Backlog

Last month the Commercial Repayment Center (CRC) held a conference call regarding the substantial backlog of unworked conditional payment claim leads. The CRC indicated that there are over 330,000 potential leads and that they have been mandated to “catch up” on collecting the monies owed to Medicare. With such a large number of leads comes the potential for an inundation of correspondence from the CRC. These leads will result in either conditional payment letters (CPLs) or conditional payment notices (CPNs). We have been working with our CRC representative regarding the best way to deal with the incoming correspondence and how the CRC prefers that we respond to the same. It is important to note that, though a CPL may result in a CPN, at the time it is issues, the CPL is simply a notification of a possible debt due to Medicare. The debt is not yet due and there is no detriment to not responding to the CPL. In fact, we have recently been advised that the CRC has put a hold on reviewing formal disputes of CPLs due to workload constraints. A CPN, however, is a notice of debt due and should be dealt with timely, as indicated by the response date listed in the correspondence. If you have questions regarding the correspondence you received from Medicare and would like our assistance dealing with the same, please reach out. We are happy to help!