Medicare Secondary Payer (MSP) - JE Part B

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 Center (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

Billing MSP via CMS-1500 Paper Form - View elements required when submitting paper claim forms for Medicare as the secondary payer

MSP Definitions - View common MSP terms and definitions

MSP Types - View a list of MSP types and definitions

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

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

Remittance Errors and Solutions - View claim denial errors by MSP reason codes

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

Resources

• Billing for Services when Medicare is a Secondary Payer
• CMS Coordination of Benefits & Recovery Overview
• CMS End Stage Renal Disease (ESRD) Center
• CMS Internet Only Manual (IOM), Publication 100-05, Medicare Secondary Payer (MSP) Manual, Chapter 3 - MSP Provider, Physician, and Other Supplier Billing Requirements
• CMS MSP Provider Services Website
• Veterans Administration