Billing Beat

TrailBlazer Website offers Medicare Secondary Payer (MSP) information

May 2, 2011

Medicare Secondary Payer (MSP) is the term used by Medicare when another payer pays primary to Medicare. Currently, Medicare is secondary payer to beneficiaries covered for health care benefits through their Group Health Plan (GHP) or a spouse’s or family member’s GHP, disability, End Stage Renal Disease (ESRD), and for automobile, no-fault liability, Workers’ Compensation (WC), Veterans Affairs (VA) and Black Lung (BL) situations. Note: VA and other federal payments are exclusions rather than MSP non-payments. To determine if Medicare is the primary payer, providers must ask the beneficiary about any additional coverage that he may have. This will ensure that providers are billing the correct primary payer prior to billing Medicare. The Coordination of Benefits (COB) contractor updates MSP records based upon receipt of notice that another payer is primary to Medicare (e.g., an explanation of benefits, a beneficiary questionnaire, or a notice from a third-party payer). TrailBlazer’s Web site offers Medicare Secondary Payer (MSP) information and educational resources to assist providers with appropriate billing of services.

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