WARNING - Calculate Final Conditional Payment Amount Can Only Be Selected Once

This is a warning page to remind you that once you click Continue, the Final Conditional Payment amount will be calculated and that you can only select this option once.

The Final Conditional Payment Amount displayed on this page includes all items or services that the Benefits Coordination & Recovery Center (BCRC) have identified as being related to the pending claim that Medicare has paid conditionally to date.

Case information displayed includes:

• Case ID
• Beneficiary Last Name
• Final Conditional Payment Amount
• Medicare ID (Health Insurance Claim Number [HICN] or Medicare Beneficiary Identifier [MBI]; HICN partially masked unless you log in to the MSPRP using multi-factor authentication)
• Final Conditional Payment Process Requested date

Please review this amount carefully. If you continue with this process, you will not be able to submit any additional disputes. Note: This amount may decrease if unrelated claims are identified when you click Continue.

Your Final Conditional Payment Amount will not increase as long as:

• Your actual settlement date is within 3 business days of requesting the amount (3 business days from the Final Conditional Payment Process Requested date)
• You provide notice of settlement information on the MSPRP within 30 calendar days of the Final Conditional Payment Requested date

If you fail to provide this information in time, additional claims may be added to your conditional payment amount.

Click Continue to proceed and calculate the Final Conditional Payment Amount.

Click Cancel to cancel the process and return to the Case Information page.