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 Member and Provider Services (MPS) 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 client informing an insurance company that an incident or injury occurred or by a returned Accident/Questionnaire which discloses an incident or injury.  The team responds to requests in chronological order of the date received.

The months above the target of 10 days are due to a high volume of cases, staff absences, as well as other annual work processes such as the Department of Motor Vehicle (DMV) data match for accidents and annual file updates.  In January of 2024, the Casualty Recovery Team began working on the annual DMV report which will conclude in July of 2024.  Additionally, the team continues to work on an ongoing backlog of accident injury questionnaires. Both activities are taking longer than expected due to an increase in overall requests, resulting in an increase to the trendline. The team added an additional staff member at the end of January 2024 to help alleviate the current backlog and increased workload.
Last updated:  06/20/24

• Medicaid Beneficiaries
• Insurance Companies
• DMV