1 / 18

MEDICARE SECONDARY PAYER

MEDICARE SECONDARY PAYER. Medicare Secondary Payer (MSP) Questionnaire. Must contain the correct answers Must come from a valid resource Must walk hand in hand with claim submission It is a tool. Coordination of Benefits. Medicare’s rules trump all others A only.. B only

watsonjack
Download Presentation

MEDICARE SECONDARY PAYER

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. MEDICARE SECONDARY PAYER

  2. Medicare Secondary Payer (MSP) Questionnaire • Must contain the correct answers • Must come from a valid resource • Must walk hand in hand with claim submission • It is a tool

  3. Coordination of Benefits • Medicare’s rules trump all others • A only.. B only • Multi-group plans • VA

  4. Employed versus Unemployed • Payroll and/or FICA Tax • Retired • Banked Hours • Long Term Disability • COBRA Coverage

  5. End Stage Renal Disease • 30 month coordination period • Employment data is irrelevant • Dual entitlement • Coverage can term, it just can’t be secondary

  6. Commercial Misconceptions • Beware the patient preference rule • Just because they pay, doesn’t mean they should • Personal policies

  7. Automobile Slip and Fall Product Liability Dog Bites Good Will Malpractice Accidents (Non-Work Related)

  8. No-Fault Insurance • Is what it says, “no fault” • Medical money only! • Policy limits are present • Policy parameters are applicable

  9. Liability • Do you hold anyone responsible? • Liability is determined by the patient • Pursuit of dollars is required • What constitutes a correct answer is subject to change

  10. Non-Cooperative Patients • The patient must be able to provide the information or action that is required • The patient must be informed that their actions will make them self-pay • Patient doesn’t have to believe you

  11. Auditor Triggers • Accidents • Improper entitlement identification • ESRD patients • Understand the questions you ask

More Related