Wiki Hospice billing, bcbs primary

[rcblack111367@gmail.com]

Hey,
I have a patient with BCBS (commercial insurance) primary and Medicare secondary. The patient elected Hospice care. BCBS has paid as the primary payer and left a balance to send to the secondary insurance company. Since the patient elected Hospice, Medicare won't pay MSP (Hospice should). In this case, would Hospice be billed as the secondary or primary payer? I am unable to locate any clear guidelines for this and in 13 years of insurance billing this is the 1st time this has happened. Any assistance would be appreciated! Thanks in advance!

 

[lkaycreasy]

Hey,
I have a patient with BCBS (commercial insurance) primary and Medicare secondary. The patient elected Hospice care. BCBS has paid as the primary payer and left a balance to send to the secondary insurance company. Since the patient elected Hospice, Medicare won't pay MSP (Hospice should). In this case, would Hospice be billed as the secondary or primary payer? I am unable to locate any clear guidelines for this and in 13 years of insurance billing this is the 1st time this has happened. Any assistance would be appreciated! Thanks in advance!

I recently had this problem, my case happened to be patient Hospice Diagnosis was for ESRD. after researching I found this to answer my questions for most of not all scenarios. Hope this helps.

https://www.medicare.gov/Pubs/pdf/02179-Medicare-Coordination-Benefits-Payer.pdf#page16

 

[rcblack111367@gmail.com]

Thanks so much!