As a continuing effort to update our readers on the Commercial Repayment Center, we are providing an update on the CRC’s progress and current issues. For our June blog update on the CRC, please click here. For our March blog update, please click here.
Franco Signor continues to engage with CRC management and staff to address ongoing implementation issues as the new CMS contractor gets settled in. As most know, the new contractor has a backlog of pending Conditional Payment Notices (CPNs) that is being held up mostly by system integration issues. We believe our proactive engagement is helping to make progress to remove the backlog and provide a pathway to for improved efficiencies in processing no-fault and worker’s compensation conditional payments where there is no settlement, judgment or award.
Some of the recent issues brought to the CRC’s attention are the following:
- CRC grouping software issues: The CRC software was pulling excessive amounts of unrelated charges and sending them out in conditional payment letters or notices, which caused a need for an increase amount of letters to be disputed. The CRC made changes to their grouping software on 7/7/2016 and spent the rest of July undergoing a Quality Assurance of all letters before they were mailed out. This caused a decrease in letters being received for the month of July.
- Sending out Demand letters when a dispute was being processed: This is another widespread issue that the CRC was having and that has been affecting the entire industry. The CRC states that a fix was put in place towards the end of July.
- CRC issuing a No Paid Claims Letter on claims that have had a Settlement and/or ORM Termination versus sending out a Demand or closure letter: The CRC’s workflow when they receive a Settlement is to close their file and send notification to the BCRC so they can open a file to issue a Final Demand/Closure letter. This process is still not working smoothly which is why we have seen an increase for all of our clients trying obtain a Final Demand and receive a closure letter from either the CRC or BCRC. We have utilized multiple approaches with both the CRC and BCRC to get these claims moving faster through the system. We will continue to work with them until there is a smooth process for all.
- Duplication of CRC & BCRC files being open and issuing demand letters at the same time.
Please contact us if you have any questions on the Commercial Repayment Center or conditional payments at firstname.lastname@example.org. We will continue to provide regular updates on the CRC as they become available.
Heather Schwartz Sanderson, Esq., MSCC, CHPE, CLMP, CMSP
Chief Legal Officer
Franco Signor LLC