Responding to a Medicare Demand Letter

  • January 15, 2020
  • |Quartz
|
As you know, information is always subject to change. There may have been updates since this blog post was published. Questions? Please contact Customer Service
shutterstock_264712940

Have you received a letter in the mail that looks something like this?

Medicare letter snip

This is called a Medicare Demand Letter. It means that Medicare mistakenly paid on a claim for one of your employees that should have been paid by Quartz. They are asking to be paid back. Typically, Medicare will send the letter to you with a copy to Quartz, so we have the same information in our files.  

What do you need to do if you receive a Medicare Demand Letter?

Please contact Quartz right away to see if we have received our copy and to confirm we will respond to Medicare. There have been some instances when an employer received a letter, but we did not. By notifying us, you can feel confident we will resolve the situation. Reach out to our Medicare Demand Specialist, Lynnaus Gilbertson, at (608) 881-8124 or lynnaus.gilbertson@QuartzBenefits.com.

You do not need to contact Medicare directly – we will interact with them on your behalf.

What happens next?

  • Our Medicare Demand Specialist may reach out to you as the employer with a request for information, based on the situation and how we need to respond to the demand letter.
  • Quartz will send you a letter about our response to the Commercial Repayment Center. To check on the status, Lynnaus Gilbertson will continue to be your contact person.

How long does the process take?

Quartz has 60 days from the date of the Medicare Demand Letter to investigate the claim and respond.

  • If we determine payment to Medicare is owed, we’ll submit payment and the matter will be closed.
  • If we don’t think reimbursement is due, there is a process for us to go back and forth with Medicare before a final determination is made. You’ll be notified of the outcome via a letter from the Centers for Medicare & Medicaid Services (CMS).

Comments

Load more comments
Thank you for the comment! Your comment must be approved first

Choose font size