Does a physician need to do a PA when MPR sends them a request?
The Medical Payment Recovery Unit is responsible for recovering Medicaid funds that have been expended on behalf of a Medicaid-eligible client where other insurance coverage should have been the primary source for payment. With some specific exceptions, providers are required to bill Third Party Liability (TPL) resources prior to billing Medicaid for the purpose of coordination of benefits. If, after 30 days, the third party resource doesn’t respond, the provider can bill Medicaid. The MPR works with insurance carriers, medical providers, clients and other state agencies to ensure payments are made by the primary payer. Medical Payment Recovery Unit • Phone: 503-378-2005 Fax: 503-391-2360 • Mailing address: PO Box 14023 Salem, OR 97309-5023 Contact information • Melvena Gorman Manager 503-378-3289 • Carolyn Thiebes Policy Analyst 503-378-3507 Related links: • Oregon Senior Health Insurance Benefits Assistance (SHIBA) • Medicare • DMAP Worker Guide • Additional consumer information (als
Related Questions
- I need to request a prior authorization for a physician in a group practice. Do I use the groups NPI or the physicians NPI when requesting the PA?
- What are the possible determinations when a review request is sent to a physician peer reviewer?
- Does a physician need to do a PA when MPR sends them a request?
