Medicare Secondaries

Can anyone help me. I thought that Medicare Secondaries could only be filed electronically. Where can I find out the information that I need to file these secondary claims. Does Medicare really pay as a secondary? Thank You!

re: Medicare Secondaries

you cannot file Medicare secondary electronic because you have to submit the claim to Medicare with primary EOB. And yes, if the patient owes a balance after the primary pays then goodness send it in! you have better luck Medicare paying than the patient.

re: Medicare Secondaries

What I find is that they pay if the primary does not pay more than their allowable.

re: Medicare Secondaries

I thought this was a Medicare rule across the board, but maybe it varies by state. Here in Missouri, Medicare will not accept paper claims at all; secondary or otherwise. And yes, if the primary carrier's allowed amount is less than Medicare's allowed amount, they will pay as secondary.

re: Medicare Secondaries

We are Part B. Our regional MAC (TrailBlazer) stopped accepting paper secondary claims a couple of years ago. Check to see if your software is capable of transmitting the "Claim Adjustment Segments" from the primary insurance electronically. Medicare will typically pay copays after commercial insurance, and up to their allowable on deductibles assessed by the primary. Medicare does require the patient to pay their calendar-year deductible first.
Also, our former MAC has a neat little MSP calculator @ https://www.noridianmedicare.com/p-medb/claims/msp/calculator.html