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Piatt Clams Resolution

Separating fact from uncertainty

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We know CMS from the inside

ORM Demand Resolution

When an insurance plan accepts Ongoing Responsibility for Medicals (ORM), that plan becomes the "Primary Plan" and Medicare is only allowed by statute to pay claims when the insurer has denied a beneficiary's claim.  Although the Coordination of Benefits Contractor (COBC) stops Medicare from paying primary, when another plan should pay, occasionally a provider or intermediary mistakenly bills Medicare. In these instances, the Medicare Secondary Payer Recovery Contractor (MSPRC) will seek reimbursement from the Primary Plan.

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When a Primary Plan receives such a "Demand," the Primary Plan must pay the Demand. If the Demand is in error, the Plan may dispute ("Defend") the individual claims or coverage under the plan.

Piatt Claims Resolution ORM DEMAND will process or defend the demand on your behalf.

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