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Medicare Secondary Payer (MSP)

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 situations when a supplier should contact the BCRC

Capped Rental with MSP - If primary insurance pays for lump sum purchase of a capped rental item (except complex rehabilitative power wheelchairs), Medicare cannot make a secondary payment. View details

MSP Claim Filing Tips - View tips for successfully submitting a claim for MSP

MSP Definitions - View common MSP terms and definitions

MSP Types - View a list of MSP types and definitions

MSP Payment Calculation Examples - View information including calculation and descriptions of Allowed Amount, Paid Amount and OTAF information from Explanation of Benefits (EOB)

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

One or Multiple Primary Payers - There may be situations where one or more than one primary insurer to Medicare makes payment on a claim. View details

Resources

 

Last Updated Oct 27 , 2023