View Submitted Defenses Page

The View Submitted Defenses page allows you to view information submitted for defense consideration via the portal, mail, or fax for the listed case ID. This page also shows the date the MSP record was accepted by CMS. This page will include claims/lines that are no longer active in the case because the defense decision was favorable, as well as claims/lines that are still active because the decisions are pending or were unfavorable.

This page lists the Commercial Repayment Center (CRC) mailing address and fax number and details for all claims or claim lines and documents submitted with the defense request. If you need to submit any additional documentation for this defense after it has been submitted, you may do so by using the Submit Documentation button on the Case Information page or by mailing or faxing the information to the CRC using the listed contact information.

You can view the following information for claim or claim lines submitted with the defense request:

• Claim Control Number
  The first eight characters are masked with an asterisk if you are not logged in using multi-factor authentication (MFA).
• Claim Line Number ("0" is used for Part A claims)
• First Date of Service
  Displays for MFA users only.
• Last Date of Service
  Displays for MFA users only.
• Billed Amount
• Medicare Paid Amount
  Defense Type
  The defense submitted by a portal user.
• Defense Received
  If a prior claim-level defense was submitted on the CRCP, "CRCP" and the defense submission date will be shown. If a defense was never submitted, this field will be blank. Otherwise, "Mail/Fax" is displayed.
• Defense Decision Code
  Displays as "Pending Review", if no decision has been made on an open defense submission, or the three-character decision code when a decision was made by the CRC. Otherwise, this field will be blank. The defense decision codes include:
  • BID: Invalid Defense Balance Due
  • DPA: Partial Payment - Debt Resolved
  • BPA: Partial Payment - Balance Due
  • DFP: Full Payment - Debt Resolved
  • DFV: Full Valid Defense Debt Resolved
• Docs Needed for Defense
  Displays up to three values (separated with a semi-colon) per claim or claim line where the defense was denied by the CRC for the associated case; otherwise, displays as blank.

Notes: Part A claims are shown first, followed by Part B claim lines. Rows are displayed in ascending order by the first date of service for Part A claims. For Part B claim lines, rows are shown in ascending order by the first date of service, and then by claim control number and claim line number. If more than one defense has been submitted for a claim or claim line, the most recent defense submission information will be shown.

You can hover over values in the Defense Type, Defense Decision Code, and Docs Needed for Defense columns to display their full descriptions.

You can also view information for documents submitted with the portal defense request:

• Defense Received
• Defense Type
• Document Name

Notes: The documents are shown in descending order by the defense received column (showing the most recent submission first), then in ascending order by the defense type and document name.

Defense documents uploaded before July 2022 will not have a defense type and will not be shown on this page.

Click Continue to return to the Case Information page.

July 2023