Guidance for Correct Claims Submission When Secondary Payers Are Involved for Medicare Providers
Submitted By Anonymous, Created 04/12/2012 - 12:27
- Collect full beneficiary health insurance information upon each office visit, outpatient visit, and hospital admission.
- Identify the primary payer prior to submission of a claim, and bill the appropriate responsible payer(s) for related services.
- For multiple services, bill each responsible payer(s) separately. Do not combine unrelated services on the same claim to Medicare
- Providers, physicians, and other suppliers should always use specific diagnosis codes related to the accident or injury. Doing so will promote accurate and timely payments.
- Providers should report directly to the COBC any changes to beneficiary, family member’s employment/accident/illness/injury, Federal program coverage changes, or any other insurance coverage info.
Source: Medicare Learning Network Matters Number: SE1217
Source URL: http://www.cms.gov/Outreach-and-Education/Medicare-Learning-...