Screening for Medicare secondary payer
All providers/practitioners should screen their Medicare patients to obtain correct health insurance information before submitting a claim to Medicare.
Patient screening is a vital step that is critical to every type of practice.
Front office staff plays a key role in the success of filing claims correctly and timely, by taking a few minutes with the patient or patient’s responsible party.
Screening question
Below are questions to ask your patient to determine whether Medicare is primary or secondary.
- Are you currently employed?
- Is your spouse or other family member currently employed? If so, how many employees work for the employer providing coverage?
- Are you or your spouse covered under an employer or union health plan that should be primary over Medicare?
- If your spouse is covered, are you also covered under his plan?
- Did you sustain an injury/illness while at work?
- Are your injuries related to an accident (i.e., is the patient being treated for an injury or illness for which another party could be held liable)?
- Do you qualify or have entitlement to black lung benefits due to coal miner’s or black lung disease?
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