Processing of Medicare Secondary Payer (MSP) claims

Effective January 6, 2025, a change will be made to the processing of MSP claims. Continue reading for details of how we currently process these claims, and how the process will change moving forward.

Current process:

• If no primary insurance address is reported for the beneficiary, we will process the claim as reported.
• If the primary insurance for the beneficiary is Blue Cross/Blue Shield (BCBS):
  • If the state of the primary insurance reported on the claim does match the address of the MSP trailer on file, the address on file is not changed, even if the rest of the address does not match
  • If the state of the primary insurance reported on the claim does not match the address of the MSP trailer on file, the address of the MSP trailer on file is changed to match the address of the MSP trailer on the claim
• If the primary insurance for the beneficiary is AETNA, the state reported on the claim does not affect claim processing

Proposed change:

• If no primary insurance address is reported on the claim for the beneficiary, the claim will be rejected
• If there is any variation between the address reported on the claim for the beneficiary and the address of the MSP trailer currently on file, the address used to process the claim will be changed to match the address for the MSP trailer on file