Forum - Questions & Answers

Oct 28th, 2011 - Shannan 28 

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!

0 Votes - Sign in to vote or reply.
Oct 28th, 2011 - padi1coder 10 

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.

0 Votes - Sign in to vote or reply.
Oct 28th, 2011 - rphelps 615  1 

re: Medicare Secondaries

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

0 Votes - Sign in to vote or reply.
Oct 28th, 2011 -

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.

0 Votes - Sign in to vote or reply.
Oct 28th, 2011 - youngblood 278 

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

0 Votes - Sign in to vote or reply.


Home About Contact Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2021 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association