Medicare Secondary Payer

Conditional payments are Medicare payments for Medicare covered services for which another insurer is primary payer, made under the condition they are subject to repayment if and when the primary payer makes payment.

The following questionnaire contains questions that can be used to help Medicare providers identify other payers that may be primary to Medicare. [CR 5087]

Do you want to know how to avoid MSP claims payment delays and inappropriate denials?

Tired of having claims returned because you didn't complete the insurance section of the CMS 1500 Form? This short tutorial focuses on how to complete the patient information section of the CMS-1500 form.

Electronic Filing of Medicare Secondary Payer Claims (MSP) for Part A

This formatting information is intended to provide you and your software IT staff with a reference point to provide the necessary MSP information for electronic claim filing in the ANSI X12N 004010X098A1 format.

When a Medicare patient’s primary payer (primary insurance) does not make payment on a claim, the reason for denial must be submitted to Medicare.

Reporting Medicare Secondary Payer Information on the Health Insurance Portability and Accountability Act of 1996 X12N 837, Created Via the Free Billing Software [Source: CMS Pub. 100-20, Transmittal 84, CR 3284, MM3284]