Revenue Cycle

Take-home hints on the MSP

Patient Access Weekly Advisor, February 11, 2009

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 #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.

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.

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