If Medicare demands an overpayment after a Medicare Secondary Payer (MSP) claim has paid, the MSP Form must be submitted along with the primary insurer Explantion of Benefit (EOB).
To avoid processing delays with MSP Part B Form, review the following:
- Use form for any MSP request pertaining to primary or secondary payment of claims
- Forward all inquiries for MSP recovery to Benefits Coordination & Recovery Center (BCRC)
- Include primary insurer EOB and/or documentation supporting insurance benefit with form
- Do not include a refund check with form
- Do not use form if requesting a Redetermination on an MSP claim that is not MSP-related
- Do not use form for a new claim submission
- Do not use form for situations that involve Veteran's Administration, PACMED or USFHP (US Family Health Plan). Use the Reopenings Form.
If sending a refund check, complete and submit MSP Voluntary Checks Form.
Last Updated Sep 12, 2017