This option allows you to request a mailed copy of the Conditional Payment Letter (CPL) for either a Benefits Coordination & Recovery Center (BCRC) or Commercial Repayment Center (CRC) case.

Note: This option is disabled when a Conditional Payment Notice (CPN) has been issued on the case (unless it was issued in error).

About the Conditional Payment Letter

This letter identifies Medicare's current conditional payment amount (as noted in the Current Conditional Payment Amount on the Case Information page) The CPL will include a Payment Summary Form that lists claims paid by Medicare that are being claimed and/or released with respect to the accident, illness, injury, or other incident. For more information on the conditional payment amount see the Request an update to the conditional payment amount help page.

Notes: If the overpayment or Current Conditional Payment Amount is equal to zero ($0.00), and the case (BCRC) is not in the Final Conditional Payment process (that is, Status is not Active, Pending NOS, or Complete), then a No Claims Paid to Date by Medicare letter is generated

Request conditions:

This action can only be performed when:

• The Case Status on the Case Information page is Open,
• Case has completed the initial claims retrieval and automation process,
• No claims on the Claims Listing page are in dispute,
• A Conditional Payment Notice (CPN) or demand:
• Has not been issued previously or is not pending, or
• Was previously issued in error.
• The Current Conditional Payment Amount on the Case Information page is greater than or equal to zero ($0.00).
  
  Note: If the Current Conditional Payment Amount is equal to zero ($0.00), and the case is not in the Final Conditional Payment process (that is, Status is not Active, Pending NOS, or Complete) (BCRC cases only), then a No Claims Paid by Medicare letter is generated.
• The case is not in bankruptcy proceedings.

For BCRC case questions, contact:

For BCRC cases, when you select the Request a mailed copy of the conditional payment letter action, the MSPRP will send the conditional payment letter to each authorized individual/entity associated to the case (i.e., the beneficiary and each individual/entity with a Verified Proof of Representation or Consent to Release on file for the case). The letters will be mailed to the address/addresses Medicare has on file which may not necessarily be the same address that is listed on the MSPRP. Please allow 3-5 days for the system to process this request and additional time for postal delivery.

The following updates will be made to the Case Information page:

Note: The Request a mailed copy of the conditional payment letter action will not update the Current Conditional Payment Amount prior to the letter being generated. However, claims are retrieved daily, so the Conditional Payment Amount displayed on the Case Information page will be up to date as of the previous day.

There may be times when new claims still need to be added to the amount. If you require an updated conditional payment amount prior to generating the conditional payment letter you must do the following:

1. Go to the Case Information page.
2. Select Request an update to the conditional payment amount. Wait until the Current Conditional Payment Amount on the Case Information page has been updated.
3. Return to the Case Information page.
4. When the Case Status has changed from Claim Retrieval back to Open, and the above conditions have been met, select the Request a mailed copy of the conditional payment letter option.

OR

1. Go to the Case Information page.
2. Select Request an update to the conditional payment amount.
3. When the system returns you to the Case Information page (from the Conditional Payment Letter Confirmation page), select Request an update to the conditional payment amount.
   
   By selecting each of these actions in this order prior to exiting the case, the MSPRP will postpone creating the letter until the conditional payment amount has been updated. Once the Current Conditional Payment Amount on the Case Information page has been updated, the MSPRP will automatically generate the Conditional Payment Letter with the new conditional payment amount.

April 2025