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Billing Medicare as a secondary

  1. #1
    Default Billing Medicare as a secondary
    Medical Coding Books
    If Medicare is secondary and the primary allows more than Medicare so Medicare won't make a payment as secondary and we know this in advance, do we still have an obligation to bill Medicare or should we be writing off the balance at time of primary payment?

  2. #2
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    Greeley, Colorado
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    I would say yes - so that it can be applied to the deductible. Here is a link to the CMS MSP manual. Good luck...
    http://www.cms.hhs.gov/Manuals/IOM/i...tNumPerPage=10
    Lisa Bledsoe, CPC, CPMA

  3. #3
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    Lisa,
    Thank you so much for your response. I really appreciate it. I had a feeling that we had too but it's always nice to have it in hard copy as a reference!
    Thanks for the link!!

    Carmel Creager

  4. Default
    I agree with Lisa. And not only would we want to have the service applied to the annual deductible, we would also want to show the patient that we did bill both carriers.

    ~L
    CPC, CGSC, COSC

  5. #5
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    I should also add that it is required that we bill medicare regardless...government agency and all...
    Lisa Bledsoe, CPC, CPMA

  6. #6
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    Quote Originally Posted by creagerc View Post
    If Medicare is secondary and the primary allows more than Medicare so Medicare won't make a payment as secondary and we know this in advance, do we still have an obligation to bill Medicare or should we be writing off the balance at time of primary payment?
    Medicare is considered secondary if the person is not retired, and if Medicare is the only insurance carrier for the patient. If patient is retired, Medicare become primary and any other secondary insurance carriers ( aka COB coordination of benefits)are billed therefore.

  7. #7
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    Quote Originally Posted by cinnamon View Post
    Medicare is considered secondary if the person is not retired, and if Medicare is the only insurance carrier for the patient. If patient is retired, Medicare become primary and any other secondary insurance carriers ( aka COB coordination of benefits)are billed therefore.
    You need to also ask the Insurance if their primary or secondary also. If the Primary Insurance covers all of the medical bill, and medicare is secondary, there's no need to bill Medicare. Medicare will only pay for the allow amount of the services and you do deduct the patients co-payment at the office and the deductible will be applied to the patient's insurance. If patient deductible are met insurance usually will cover at 100% depending on the insurance carrier.

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