This page is used to capture information for the Account Representative (AR) associated with the Representative account type. The AR is the individual in your organization who has the legal authority to bind the organization to a contract and the terms of the Medicare Secondary Payer Recovery Portal (MSPRP) requirements. This is usually a senior executive/partner of the company/firm.

AR Responsibilities

• WILL NOT be a user of the system for this account, for corporate accounts-see stipulations below.
• Has ultimate accountability for the information submitted on the MSPRP. The AR must approve the organization's profile during the initial account setup and through any subsequent changes.
• May perform the New Registration step on the MSPRP (or designate this task to someone else).
• Receives the post-registration email (at the email address entered on the Representative Information page). This email contains the Personal Identification Number (PIN).
• Provides the account ID (shown at the end of Step 1 - New Registration) and the PIN (from the email) to the designated Account Manager (AM) for the account. The AM will use this information to complete Step 2 - Account Setup. The AR must approve the account setup by physically signing the Profile Report, including the Data Use Agreement, and returning it to the Centers for Medicare & Medicaid Services (CMS).
  
  Note: The Profile Report is sent after the Step 2 - Account Setup is completed. It contains a summary of the information you provided on your registration and account setup, as follows:
  • A Data Use Agreement;
  • Your account ID; and
  • Contact information for the Benefits Coordination & Recovery Center (BCRC) Electronic Data Interchange (EDI) Department.

AR Stipulations

• An AR for an MSPRP representative account can be a user (i.e., an AM or Account Designee [AD]) with a login ID for any other MSPRP account (i.e., can be an AR for an account and registered as an AR, AM, or AD for any other MSPRP account, or an AR, AM, or AD for other COB&R systems, i.e., Workers' Compensation Medicare Set-Aside Portal [WCMSAP], Section 111 Coordination of Benefits Secure Website [COBSW], or the Commercial Repayment Center Portal [CRCP]).
• An AR for a representative account can register as an AR for multiple accounts on the MSPRP.

AR Information Fields

Account Representative Information Fields

Field	Description
First Name	Given or first name of AR.
MI	First letter of AR's middle name.
Last Name	Surname of AR.
Social Security Number	The AR's Social Security Number (SSN). This number must be unique in the MSPRP. It cannot be registered for more than one account. It cannot be the same as the SSN of the associated beneficiary.
E-mail Address	AR e-mail address.
Re-enter E-mail Address	Second entry of the AR's e-mail address for verification purposes. This information cannot be cut and pasted. Note: This e-mail cannot match that of an AM or AD user of the MSPRP. If you erroneously provide the e-mail address of your AM or an AD, those individuals will be unable to register as users of the MSPRP.
Phone	AR's phone number.
Ext	Company or work telephone extension where the AR can be reached.
Fax	Fax number used by the AR. Note: This field is not required.

Mailing Address

Note: Submitting an address change on the MSPRP will not automatically change your address on existing cases. To make a permanent address change to existing cases, please see the section titled "How to Submit a Permanent Address Change" in the MSPRP Registration Guidelines and Scenarios

Mailing Address Fields

Field	Description
Address Line 1	First line of the mailing address for the AR.
Address Line 2	Second line of the mailing address for the AR. Note: This field is not required.
City	Mailing address city for the AR.
State	Mailing address state for the AR. This is selected from a drop-down menu.
Zip Code	Five-digit ZIP code and four-digit ZIP+4 code for the AR. Note: The Zip+4 field is not required.

Click Previous to return to the Select Account Type page.

Click Continue to proceed to the next page in the New Registration process, which is the Beneficiary Information page.

Click Cancel to cancel the New Registration process and return to the Welcome to the MSPRP (Login) page.

July 2022