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Medicare Clients - How to Get Updated Claims Information

November 9, 2010

By Janet Decker, MS

Has this ever happened to you? Your attorney asks for the Medicare conditional lien amount and you have to explain that you have called, faxed, and sent letters only to be told it could take up to 45 days, plus 7 mailing days before you receive the conditional lien or an update. I know that my attorney is never happy with that answer; he wants a number. Here is a quick and easy way to get that number -- have your client do it. Yes, that's right...the client. The client's Medicare claim(s) information is updated EVERY week. By utilizing the website https://www.mymedicare.gov/, the client can create an account and log in to see the status of their Medicare claim(s).

Click on the "Claims" button at the top of the page.
There are then several options to view claims, such as: service date range from start date to end date; the last 3 months; 6 months; 9 months; or all claims in history. I find that the best option is to have them select "start date" with the date of the incident and "end date" as the date of their last treatment, or if still treating, the current date and then select "All Claims."
Once the first page of the claims paid information appears, select "View all Pages."
The client will be given the option to "Download My Data". The client can do this and print out the claims information or simply hit the "CtrlP" function to print this information out for the paralegal.

The claims paid information will contain all claims incident related or not. However, the paralegal and the client will be able to select the ones that are incident related. With the use of a calculator or Microsoft Excell, it is easy to add up the column "Medicare Paid to Provider." This sure beats waiting 45 days, plus mailing to get a reasonably good condition lien number for your attorney.

Of course, this will not eliminate requesting the Medicare conditional lien in the first place and updates, or even that all important Final Lien. But this method is a good tool for getting a ball park Medicare conditional lien amount for your attorney.

What about the elderly clients that are not so computer savvy or are not able to do this for you? I suggest that when your attorney has been retained by a client on Medicare, that you sit the client down at a computer in your office to have them create their https://www.mymedicare.gov/ account and have the client give the attorney permission to have access to and use of this site until the case has been settled and disbursed. Be sure to ask your attorney first! An authorization may need to be created and signed by the client.

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DISCLAIMER: Barbara Haubrich-Hass, ACP/CAS, is not an attorney. Any information derived from The California Litigator, and any other statements contained herein, are for information purposes only, and should not be construed as legal advice or a recommendation on a legal matter. The information from The California Litigator is not guaranteed to be correct, complete, or current. Barbara makes no warranty, express or implied, about the accuracy or reliability of the information provided within this article, or to any other website to which this article may be linked.