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 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 Payer 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
Obligated to Accept Field (OTAF) - View an explanation of how to determine OTAF
- CMS Internet Only Manual (IOM), Publication 100-05, Medicare Secondary Payer (MSP) Manual, Chapter 3 - MSP Provider, Physician, and Other Supplier Billing Requirements
- CMS Medicare Learning Network (MLN) Matters (MM)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
Last Updated Feb 27, 2020