medicare secondary payer, clearing the hurdles of compliance kevin willis director of medicare...
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Medicare Secondary Payer, Clearing the Hurdles of ComplianceKevin WillisDirector of Medicare Operations, Claim Services Inc
Medicare Secondary Payer (MSP) QuestionnaireMust contain the correct answers!
Must come from a valid resource
Must be completed for all Medicare patients..
Reasons for EntitlementEntitlement due to age, disability, or End Stage Renal Disease (ESRD)
At 65, age provision takes over
Must allow for dual entitlement
Age EntitledMedicare entitlement, beginning of month patient turns 65.
20 or more employees
Retirement dates defaults
Disability100 or more employees
Family member of any kind
Retirement date equals last date worked
End Stage Renal Disease30 month coordination period
Employment data is irrelevant
Coverage can term, it just cant be secondary
General Questionnaire DataWorkers Compensation
Department of Veterans Affairs
Accidents (Non-Work Related)Automobile
Slip and Fall
No-Fault InsuranceIs what it says, no fault
Medical money only!
Policy limits are present
Policy perimeters are applicable
LiabilityDo you hold anyone responsible?
Liability is determined by the patient
Pursuit of dollars is required
Can be multiple responsible parties
Non-Cooperative PatientsThe patient must be able to provide the information or action that is required
The patient must be informed that their actions will make them self-pay
Improper entitlement identification
Understand the questions you ask