WCRC contractor transition webinar held with The Centers for Medicare and Medicaid Services

The Centers for Medicare and Medicaid Services (CMS) held a webinar on March 7, 2018, to introduce Capitol Bridge, LLC, our new WCRC contractor, and review the transition plan.

John Jenkins of CMS and Holly Havens of Capitol Bridge discussed the transition between the two WCRC contractors—the incumbent, Provider Resources, LLC, and Capitol Bridge. The last day for Provider Resources will be March 16, 2018, with Capitol Bridge beginning March 19, 2018. The transition will occur over the weekend and should not disrupt business or cause a backlog.

During the webinar, Ms. Havens confirmed the following points regarding the transition:

  • Capitol Bridge has 25 years of CMS support experience and is well versed in Medicare Set Asides. Their staff includes nurses and attorneys who are MSCC certified, pharmacists and administrative staff. Additionally, some of the existing Provider Resources WCRC staff are transitioning to Capitol Bridge.
  • There will be no change to quality or timeliness standards
  • After receipt of a submission the turn around time periods will be:
    • 20 days from the receipt of the submission, if the file does not require any further documentation
    • For a file requiring submission of additional information, the turnaround time for completion is 10 days from the receipt of all necessary documentation (a development letter will be sent).

Capitol Bridge’s contact information is:

Phone: 833-295-3773
Fax: 585-425-5390
Email: wcrc@capitolbridgeLLC.com
All correspondence must include a case control number
Operating hours are 9:00 a.m. to 5:00 p.m. eastern time, Monday through Friday

CMS stated that they expect this transition to be seamless. Mr. Jenkins confirmed no changes or updates will occur to the existing WCMSA Reference Guide and other policies and pricing will not be affected.

Optum looks forward to working with Capitol Bridge on WCMSAs, and is hopeful that the transition will be smooth and seamless as indicated. We will monitor the transition beginning March 19 and keep the industry updated on any new events or issues that arise.

This entry was posted in News Bulletins on by .

About Donna Mize, MSCC

Donna Mize is the Supervisor of MSA Submissions at Optum Settlement Solutions and manages a team of highly experienced MSA Specialists and Coordinators.  Donna has over 30 years of experience in the workers’ compensation industry and liability claims, with the past 16 years focusing on Medicare Secondary Payer (MSP) compliance. Donna has held multiple key positions within the Settlement Solutions organization, including quality control, training, and various management positions.  She is Medicare Set Aside Consultant Certified (MSCC). Prior to joining Optum, Donna was a workers’ compensation claims supervisor with a national insurance company and attended the University of South Florida.

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