Wiki Medicare secondary to auto

[penguins11]

Hi, I am looking for any suggestions someone may have. When Medicare is secondary to auto we have a lot of problems getting paid. Medicare states that they need the auto loss run in addition to the benefit exhaust letter. The auto insurance will only release the auto loss run to the patient and we have problems getting this from the patient. Does anyone have any suggestions as to how to solve this?

 

[sleonard1118@gmail.com]

I have submitted and MCR has paid with the EOB from the auto insurance carrier. The EOB from the primary payer (auto) has sufficient information for MCR to see that the auto carrier did not pay once the auto has exhausted.

 

[penguins11]

In Pennsylvania, a lot of our auto carries do not give specific EOB information stating the date of service, charge and denial reason. We get a generic letter stating that benefits have been exhausted.