Feb

10

Hints for when Medicare is the secondary payer

By Patient Access Weekly Advisor

Medicare is the secondary payor when:

• The patient is 65 or older 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’ compensation
• 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

Additional MSP tips:

• When Medicare is the secondary payor, the primary payor is first in the sequence of payors
• Medicare is second in the sequence of payors when Medicare is the secondary payor
• MSPs are to be completed on each registration to ensure proper billing