Medicare Compliance & Reimbursement

For even more resources, check out MLN Matters SE1217.

When Part B practices perform self-audits, they often report that their top errors include Medicare Secondary Payer (MSP) claims being billed as primary. You can avoid this common error, and other MSP denial issues, if you take heed of CMS's MSP instructions, presented in MLN Matters SE1217.

1. Ask Patients About All of Their Insurers. When a patient presents for a visit, you should ask him for all of his insurance cards. Otherwise, a patient may present only his Medicare identification card, failing to give you any additional cards. This could cause unnecessary denials if you're inappropriately billing Medicare as primary.

2. Bill Primary Payer First, Not Simultaneously. You can't submit claims to the patient's primary payer and the MSP at the same time. Instead, you must bill the primary payer and then wait for the remittance advice from that insurer before you submit to the MSP.

To read the complete MLN Matters article, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/SE1217.pdf.