Post-Settlement Conditional Payment Resolution with the BCRC

The Benefit Coordination and Recovery Contractor, or BCRC, is the recovery agent for Medicare liens. Understanding BCRC processes is the key to a smooth post-settlement disbursement process. And with Medicare coverage increasing to nearly 20% of the population, the BCRC’s processes matter more than ever.

 

But there’s another important player: the Commercial Repayment Center, or CRC. To understand how BCRC and CRC processes differ, we need to be clear on a Medicare lien term: debtor. The debtor is whomever Medicare thinks should be paying for that Medicare lien claim.

 

CRC has two types of recovery files: Workers’ Compensation and No-Fault. For both, Medicare considers the insurance carrier the debtor and will only accept repayment from that insurance company. It almost always is only collecting for what it calls “Ongoing Responsibility for Medicals” or ORM.

 

BCRC handles recovery for cases where the debtor is the injured person (this person is also the Medicare beneficiary and plaintiff/claimant in the matter). BCRC files include Liability and No-Fault type files where a payment is made directly to the plaintiff. The BCRC can only make Final Demands after settlement has occurred. To complicate matters, BCRC will open new claim files for each payment or settlement. This means that an underinsured motorist case’s settlement and the standard bodily injury (third party) settlement should lead to two BCRC Medicare lien files. If the plaintiff has a PIP or Med-Pay claim paid directly to them, then Medicare may eventually open a third claim for No-Fault too. Then, the CRC may already have a file open for the No-Fault claim where it is attempting to collect from the insurance carrier.

 

Medicare liens are often more complex than meets the eye. Remember that there may be multiple Medicare liens for the same plaintiff. If you need help with Medicare liens, Medicaid liens, or any other health insurance lien, contact MASSIVE at 833-466-2774.

 

Ryan Weiner, MASSIVE’s COO, will discuss this topic in-depth at the virtual 5th Annual Medicare Secondary Payer Conditional Payment Forum on July 28 at 10:10 a.m. EST. Don’t miss this chance to learn how to best advocate for your beneficiaries. Register today and use code SPKR15 for 15% off!