MSP - Medicare Secondary Payor Article

Dear RxDME2000 and DMEFree user,

 

We hope that providing you with important articles from Medicare will help you during this tough economic environment.

 

This article is about MSP - Medicare Secondary Payer, some clients have one claim a year others 30 a month or so.  I found it answered a lot of questions in terms I could understand.

 

This was the email from- CMS CMSProviderResource

A new Medicare Secondary Payer Fact Sheet  (April 2009), which provides a general overview of the MSP provisions for individuals involved in the admission and billing procedures at provider, physician, and other supplier settings is now available in downloadable format from the Medicare Learning Network at: http://www.cms.hhs.gov/MLNProducts/downloads/MSP_Fact_Sheet.pdf

I have also attached the sheet to this email

 

Some additional information;

The way RxDME2000 and DMEFree process MSP claims is via our Real time processing system.  This is a good and bad thing,, it's good because you can send the MSP claim in real time getting back an immediate response, but it's bad becuase it's expensive. There is a $25.00 minimum per month when you send MSP claims.

If you don't send any in a month there is no charge at all.

 

But there are some additional bonus's for using the MSP real time system.  Your monthly minimum allows you up to 38 transactions ($25.00/.65=38).  You can use these transactions for

1. Real time MSP claims

2. Real time Eligibility checks - please see note below from one of our users.

3. Real time Claims

 

Real time Claims, when you have a claim that is just not getting paid its useful to process it via the Real time Claims system.  The claim is checked against the logic Medicare uses to Pay the claim, not just accept it.

 

Real time MSP - even if you do one MSP claim a month it's worth sending it electronically to get paid.

 

Real time Eligibility - this note from our client Jim Buteyn, DME biller and Accreditation consultant,  says it all

 

" the Eligibility program is an incredibly invaluable tool when it comes to MSP.  By using it, I can catch the MSP before my clients waste any time obtaining documentation, etc. and more importantly, they do not deliver only to be denied by Medicare because of MSP.  The Eligibility program prevents that from happening because it shows if the beneficiary has a MSP and the effective date of the MSP. "  You may quote me if you wish! Jim

 

 

Thank You and have a wonderful spring weekend!

 

Mike Feldman

PCSolutions

www.dmefree.com

fax 203 413 5772