Question: What happens if a provider submits a claim without the other insurer’s information?
Patient Financial Services Weekly Advisor, September 19, 2008
Learn the answer from CMS.
Answer: The claim will be paid, but you will be asked to complete a Medicare Secondary Payer (MSP) development questionnaire. If, as a result of this process, an MSP situation is identified, Medicare will review its payment and may initiate recovery of the conditional payment when appropriate. Recovery will be sought from providers, beneficiaries, or other parties that have a legal obligation to repay Medicare. This claim must be reprocessed to reflect Medicare as the secondary payer. The Medicare supplier or provider must secure information about other health coverage insurance to bill the other insurer.
Source: Centers for Medicare & Medicaid Services
Comments
0 comments on “Question: What happens if a provider submits a claim without the other insurer’s information? ”
Related Products
-
Recovery Auditor Report
The Recovery Auditor Report is a free biweekly e-newsletter of useful tips and strategies to get you prepared for the...
-
Medicare Update for CAHs
Medicare Update for CAHs is a free bi-weekly ezxne that provides specialized information for our CAH (critical access...
Most Popular
- Articles
-
- HIPAA Q&A: Answering service messages
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Q&A: Coding for dry skin due to cold weather
- Q/A: Volume requirement for reporting hydration services
- Are your workforce members texting PHI?
- Topic: CMS, OESS post new security compliance review information, checklist
- What does case-mix index mean to you?
- Privacy, security concerns high in HIEs
- QA:Coding multiple initial infusions
- OB services: Coding inside and outside of the package
- E-mailed
-
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Q/A: Volume requirement for reporting hydration services
- HIPAA Q&A: Level of encryption needed for email
- HIPAA Q&A: Answering service messages
- HIPAA Q&A: TPO disclosures to a business associate
- Are your workforce members texting PHI?
- Q&A: Coding for dry skin due to cold weather
- Hospitalist-surgeon comanagement has no effect on outcomes
- Don't let these sentinel events trigger falsely
- Correctly bill ancillary bedside procedures in addition to the room rate
- Searched