If you choose to settle your personal injury claim without a lawyer and your medical treatment was paid by Medicare, there are certain steps you must take to protect Medicare’s rights. At some point in the process, you should receive a Conditional Payment Letter from Medicare. In this letter, there will be a payment summary form in which Medicare will list all medical treatment that it paid for which it believes is related to your personal injury claim.
This list is what Medicare relies on when determining how much money you have to pay it back for medical expenses it paid on your behalf. However, this list is often wrong and often includes medical treatment unrelated to your slip and fall, car accident, medical malpractice or other liability claim. Thus, it is important for you to carefully review the diagnostic codes on the payment summary form to make sure they are related to your claim. Once you have done this, you will need to send a letter to Medicare disputing the charges it is improperly billing you for. Although I recommend using an experienced injury lawyer for this process, below is a form letter you can use if you would prefer to do it yourself.
MSPRC – NGHP
P.O. Box 138832
Oklahoma City, OK 73113
Re: MEDICARE CONDITIONAL PAYMENT DISPUTE
Claimant Name: _____________________
Injury date: _____________________
I dispute the inclusion of the Medicare payments circled on the attached Payment Detail sheet for the reason that the payments were for treatment unrelated to the injury involved in the personal injury claim involved in this case.
Note that only medical treatment for ICD-9 Diagnosis codes _________________________________ are properly related to the injury involved in this personal injury case.
Please remove the dispute payments and issue a new conditional payment letter.
Ask a West Virginia Injury Lawyer for Help
If you would like assistance with your West Virginia personal injury claim or handling Medicare’s lien levied against your personal injury settlement, feel free to contact a Charleston, WV personal injury attorney at West Law Offices for a free consultation. Our toll free number is 877-943-9378.