CMS announces accessibility to Open Debt Reports

Rafael Gonzalez
| Nov 20, 2019

The Centers for Medicare and Medicaid Services (CMS) recently published Version 4.7 of the Medicare Secondary Payer Recovery Portal (MSPRP) User Guide. A notable update in this version is accessibility to Open Debt Reports for account managers. As stated in the user guide, the Open Debt Report page displays the status of open debts with account receivable balances greater than zero.

Open Debt Reports now available
The Open Debt Report is a valuable tool for applicable plans to keep track of their outstanding recovery debts. With this new release, the MSPRP Welcome Page now includes a link to the Open Debt Report section where the status of open debts for Non-Group Health Plans (NGHP) insurer-debtor cases is provided.

Notable updates
Section 6.1.1, Accessing the MSPRP, addresses the Account Designee Home Page. This subsection now includes clarification of the Open Debt Report status of open debts for NGHP insurer-debtor cases. The report is only available to account managers and is created per Account ID on cases that carry a balance greater than zero.

Section 12.3, Case Listing, addresses View of the Open Debt Report. This subsection now includes clarification of the Open Debt Report page providing the status for open debts on-demand (data is refreshed nightly), for NGHP insurer-debtor cases. This report is based on Account ID and visible to account managers only. Only cases with a balance greater than zero appear on the report. The report displays a maximum of 1,000 cases and all information is read-only.

The Open Debt Report is accessible to account managers only
Each MSPRP account must have an assigned account manager, established during the Account Setup process. This individual is a registered user of the system and controls the administration of an organization’s account, manages cases and access to case information.

For Representative accounts, account managers have the option to assign the account manager role to another person. To designate an account manager, the account representative of the corporate account must contact the Electronic Data Interchange (EDI) department to request and carry out such a change.

Account manager responsibilities include registering on the MSPRP, obtaining a login ID and password, and completing account setup. Account managers can invite other users to register on the MSPRP and function as Account Designees for a specific account. Additionally, account managers can:

  • Revoke/remove an Account Designee’s access to a case and/or an entire MSPRP account
  • Change their personal information
  • Update account contact information (e.g., company name, recovery case mailing address)
  • Submit new case requests for the MSPRP account they are associated with
  • View/manage cases that they are associated with (i.e., cases they successfully requested access to)
  • Replace an account representative for the MSPRP account
  • Remove a case(s) from the account
  • Report a case on behalf of a beneficiary or an insurer
  • View the CRC NGHP Open Debt Report

Steps for viewing the Open Debt Report

  1. Log into MSPRP, the Account List page should appear.
  2. From the Account List page, click on an Associated Account ID. The Welcome page should appear.
  3. Click on the Open Debt Report link.
  4. The Open Debt Report should appear. It will display up to 1,000 cases.
  5. To narrow down the results, enter a demand date range and click Search.
  6. To export the list to Excel, click Export to Excel.
  7. Click Cancel to return to the MSPRP Welcome page.

The Open Debt Report provides account managers with detailed CRC conditional payment demand status, including:

Field Description
Case ID The unique case identifier assigned by the Centers for Medicare & Medicaid Services (CMS).
Insurer Name The name of the insurer associated with a case.
Insurer TIN The insurer Tax Identification Number (TIN).
RRE ID The Responsible Reporting Entity (RRE) ID number.
Recovery Agent/TPA Name The name of the Recovery Agent or the Third-Party Administrator (TPA). Note: This field may be blank.
Beneficiary First Name The first name of the beneficiary listed on the case.
Beneficiary Last Name The last name of the beneficiary listed on the case.
Demand Letter ID The Demand Letter or correspondence ID.
Demand Letter Date The date on the Demand Letter (mm/dd/yyyy)
Insurance Claim Number The insurance claim number provided by the case lead, if available. Otherwise, the field will be blank.
Original Demand Amount The original Demand Amount sent by CMS.
Current HIGLAS Amount The current debt amount as reported by the Healthcare Integrated General Ledger Accounting System (HIGLAS).
Current Status of Debt The current status of the debt as reported by HIGLAS.

Optum Settlement Solutions will assist its clients with accessing Open Debt Reports to facilitate tracking, management, and ultimately resolution of conditional payments recovery with the Commercial Repayment Center.

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