Print this page 
This page confirms that you have successfully submitted settlement information for the Case ID displayed at the top of the page. The beneficiary's Medicare ID (Health Insurance Claim Number [HICN] or Medicare Beneficiary Identifier [MBI]) and Beneficiary Last Name are displayed at the top of the page. The file names of any documentation submitted to support the settlement information will also be listed.
Note: HICNs are masked unless you are the beneficiary, or you have logged in using multi-factor authentication.
Click Print this page to make a copy of the disputed claims for your records.
Click Continue to return to the Case Information page.
Next Steps:
Please allow 20 days for the Centers for Medicare & Medicaid Services (CMS) to review the settlement information and supporting documentation. CMS will contact you if any additional information is needed. If the settlement information and documentation submitted are complete, CMS will issue a final demand, bill, or case closure notice. The following updates will be made to the Case Information page depending on the action CMS takes:
Final Demand: This means that CMS has issued or is in the process of issuing a formal demand letter advising the debtor of their payment responsibility. The demand letter is sent to formally advise the debtor of the amount of money owed to the Medicare program and reflects a pro rata share reduction for fees and costs. This letter explains the Medicare Secondary Payer (MSP) recovery process.
Note: Interest accrual will be accessed every 30 days from the date of the Final Demand Letter if payment is not received within 60 days of the date of the letter.
| Field | Updated Value |
| Case Status | Demand |
| Demand Letter Mail Date | Date the Demand Letter was issued |
| Demand Amount | Final demand amount included in the letter |
Bill Issued: This means that CMS has approved the Fixed Percentage Option Request and has issued a bill to the beneficiary for the amount due. Payment must be received within the timeframe specified on the bill.
| Field | Updated Value |
| Case Status | Bill Issued |
| Demand Letter Mail Date | Date the bill was issued |
| Demand Amount | Final demand amount included in the letter |
Case Closure: This means that CMS has terminated recovery efforts for the case and has issued a case closure notice. Case closure may occur when a case should not have been created, (e.g., the case was created for an incorrect date of incident, or the beneficiary was not eligible during the MSP coverage period).
| Field | Updated Value |
| Case Status | Closed |