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Last Modified: 9/30/2018 Location: FL, PR, USVI Business: Part A

Direct Data Entry (DDE) process to allow submission of Medicare A (Medicare Secondary Payer) MSP claim information

Beginning with claims received on or after January 1, 2016, the Centers for Medicare & Medicaid Services now allows Medicare Part A DDE claim submitters to submit claim adjustments when there is one or more payers primary to Medicare via DDE. Claim submitters are to use the new DDE screen MAP1719 for claim level adjustments and the Coordination of Benefits (COB) payer paid amounts. To access the new MAP1719 screen press F11 from page three (MAP1713). The new MAP1719 screen allows DDE claims submitters up to two iterations of MSP Payment information (MSPPAY). If more than one iteration is needed simply press F6 from the first MSP payment information screen.
In the Required Primary Payer MSP field, enter the paid date of the claim and total amount the primary payer paid. Required information for each group and claim adjustment reason code (CARC) adjustment calculations should be the difference between the billed amount and the amount the primary payer paid.
For more information on MSP claim filing guidelines visit the MSP and conditional payment request claim filing guidelines page and the MSP value codes and payer codes page.
Source: CR 8486 external pdf file
Source: CR 8486
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