This measure represents the response time of the Casualty Recovery Team when an insurance company is involved in the recovery of Medicaid monies for previously paid services.

Insurance companies outreach the Coordination of Benefits Unit’s Casualty Recovery Team via phone, fax, email, and mail to verify Medicaid coverage of their client and to obtain the total amount of claims paid. Interaction begins with the insurance company notifying the department that an incident or injury occurred or by a returned Accident/Questionnaire from a member which discloses an incident or injury.  The team responds to requests in chronological order of the date received.

 As illustrated in the graph, our desired processing time is ten days or less.  The months above the target are due to a high volume of cases, staff absences, as well as other annual work processes such as the Department of Motor Vehicle data match for accidents, annual file updates, and sending files to public records.  The team added an additional staff member in March of 2025 to help alleviate the current backlog and increased workload.  As of the end of March 2025 we have another staff member on leave.
 

Narrative Updated:  03/31/25

• Medicaid Beneficiaries
• Insurance Companies
• DMV