Lien Resolution Services Forms

     

 

Additional Forms:

Proof of Representation
To be completed by claimant. Allows Medicare/Contractors permission to discuss the case with maps Lien Resolution Services.

HIPAA Release
To be completed by claimant. Allows all non-Medicare entities permission to discuss the case with maps Lien Resolution Services.

Final Settlement Detail Document
To be submitted with case settlement details to obtain the Final Demand Amount from Medicare/Part C Plans.