Reporting a WC case and Obtaining Conditional Payment Information

All Workers' Compensation (WC) occurrences that involve a Medicare beneficiary should be reported to the Coordination of Benefits (COB) Contractor. If you would like to report a WC case, obtain conditional payment information, or have a general WC question, please contact the COB Contractor by phone or mail. Customer Service Representatives are available to provide you with quality service Monday through Friday, from 8:00 a.m. to 8:00 p.m., Eastern Time, except holidays. The COB Contractor's toll free number is 1 (800) 999-1118 or TTY/TDD: 1 (800) 318-8782 for the hearing and speech impaired.

Written reports of WC occurrences should be addressed to:

Medicare—Coordination of Benefits
MSP Claims Investigation Project
P.O. Box 33847
Detroit, MI 48232

NOTE: This mailing address is for reporting a WC occurrence, not for the submission of Workers' Compensation Medicare Set-aside Arrangement (WCMSA) proposals.  WC settlements that include a proposed WCMSA for review should be sent to CMS C/O Coordination of Benefits Contractor, P.O. Box 33849, Detroit, MI 48232-5849.

When contacting the COB Contractor to report a new WC occurrence by phone or by mail, please be sure to have the following information available:

• Your client's name
• Your client's Medicare Health Insurance Claim Number (HICN) or SSN
• Date of incident
• Nature of illness/injury
• Name and address of the WC insurance carrier
• Name and address of the legal representatives
• Name of insured
• Policy/claim number

Once this information is received, the COB Contractor will apply it to the claimant's Medicare record, assign the case to a Medicare contractor, and inform you and your client of the applicability of the MSP program and Medicare's recovery rights. You will receive a notice advising you of the Medicare contractor assigned to handle the specifics of the case for recovery, Medicare's right of recovery and a beneficiary consent to release form. Once this process is completed, all further inquiries must be made through the assigned Medicare contractor. Please note that Medicare's interests cannot be determined until the claimant's record has been annotated with the specifics of the WC occurrence.