MEDICARE SECONDARY PAYER Medicare Secondary Payer MSP Questionnaire

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MEDICARE SECONDARY PAYER

MEDICARE SECONDARY PAYER

Medicare Secondary Payer (MSP) Questionnaire Must contain the correct answers Must come from a

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 Multi-group

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

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

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

End Stage Renal Disease 30 month coordination period Employment data is irrelevant Dual entitlement

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

Commercial Misconceptions Beware the patient preference rule Just because they pay, doesn’t mean they

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

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

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

No-Fault Insurance Is what it says, “no fault” Medical money only! Policy limits are

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

Liability Do you hold anyone responsible? Liability is determined by the patient Pursuit of

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

Non-Cooperative Patients The patient must be able to provide the information or action that

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

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

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

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