Last Modified: 10/17/2018 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 .
Source: CMS website
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