Lien Resolution Services Forms

Types of Cases to Submit

Lien Search

Medicare Set Asides (MSAs)

Consulting Services

Email Referral Form to resolutions@maps-adr.com

Class Action/Mass Torts

Email Referral Form to resolutions@maps-adr.com

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.

CRC Letter of Authority

To be placed on your letterhead and submitted to us to establish authority with the CRC.