skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. Information for Medicare beneficiaries is only available on the medicare.gov website.
En Español
Text Size:
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]
Last Modified: 10/19/2017 Location: FL, PR, USVI Business: Part B

How do providers determine when Medicare is the secondary payer?

Q. How do providers determine when Medicare is the secondary payer?
A. Providers are responsible to collect patient data, asking questions related to employment and other insurance, to identify payers other than Medicare. This action minimizes incorrect billing and Medicare overpayments. Providers must determine if Medicare is the primary or secondary payer by obtaining MSP information such as group health coverage through employment or non-group health coverage resulting from an injury or illness. Patients should be questioned at each visit to determine if there have been changes in insurance coverage or if there may be other insurer liability. Refer to CMS’ Part B Other Insurer Intake Tool: https://www.cms.gov/Medicare/Coordination-of-Benefits-and-recovery/ProviderServices/Downloads/pro_othertool.pdf external link.
list item Please use your browser's back button to return to the referring page.
Source: CMS website
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.