Medicare Secondary Payer (MSP) - JE Part A

Medicare Secondary Payer (MSP) is the term used to describe when another payer is responsible for paying a beneficiary's claims before Medicare pays. Noridian protects and preserves the Medicare Trust Fund by ensuring that Medicare benefits are coordinated with all other appropriate payers and Medicare pays only when and what it should pay.

Benefits Coordination & Recovery Contractor (BCRC), GHP - View crossover claim related information

BCRC, NGHP - View when to contact BCRC and what they are unable to assist with

Billing MSP Electronically - View Noridian Electronic Data Interchange Support Services (EDISS) guide that illustrates proper claim submission for Medicare as the secondary payer

MSP Definitions - View common MSP terms and definitions

MSP Form Locators - View form locators required for billing MSP claims

MSP Types - View a list of MSP types and definitions

MSP Payment Calculation Examples - View scenarios which include the primary insurance company's payment, the provider's billed amount, Medicare's allowed amount, deductible, coinsurance and Medicare's payment

MSP Tertiary Claims - View instructions for billing MSP claims when Medicare is third payer - More than One Primary Payer with Different Allowed Amounts

Obligated to Accept Field (OTAF) - View an explanation of how to determine OTAF

Resources

• Billing for Services when Medicare is a Secondary Payer
• CMS Internet Only Manual (IOM), Publication 100-05, Medicare Secondary Payer (MSP) Manual, Chapter 3 - MSP Provider, Physician, and Other Supplier Billing Requirements
• CMS Change Request (CR) 8486 - Instructions on Utilizing 837 Institutional Claim Adjustment Segment (CAS) for MSP Part A Claims in Direct Data Entry (DDE) and 837I 5010 Claims Transactions
• CMS Medicare Secondary Payer
• CMS Medicare Secondary Payer Booklet