MSP COMPLIANCE: Take-home hints on MSP
Editor’s note: Dunn Memorial Hospital in Bedford, IN, uses these hints to help its patient access staff members successfully complete the Medicare Secondary Payer Questionnaire.
Medicare is the secondary payor when:
- The patient is 65 or over and the patient or the patient’s spouse is still employed and has insurance through that employer.
- The patient is under 65 and the patient or patient’s spouse is employed by an employer with 100 or more employees and has insurance through that employer.
- The claim is workers comp.
- The claim is a Black Lung claim.
- The claim is a result of an accident and liability insurance is available.
- The claim is for ESRD and the patient is still in the 30-month coordination of benefits period.
- When Medicare is the secondary payor, the primary payor is #1 in the sequence of payors.
- Medicare is #2 in the sequence of payors when Medicare is the secondary payor.
- MSPs are to be completed on each registration to ensure proper billing.
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