J11 Part A Medicare Secondary Payer (MSP ... - Palmetto GBA
J11 Part A Medicare Secondary Payer (MSP ... - Palmetto GBA
J11 Part A Medicare Secondary Payer (MSP ... - Palmetto GBA
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
<strong>MSP</strong> Questionnaire (<strong>MSP</strong>Q)<strong>Part</strong> I: Relates to Black Lung, GovernmentPrograms and Workers’ Compensation<strong>Part</strong> II: Relates to Liability and No-Fault Plans<strong>Part</strong> III: Covers Why the Beneficiary is Entitled to<strong>Medicare</strong><strong>Part</strong> IV: Addresses Working Aged Beneficiaries<strong>Part</strong> V: Requests Additional Information forDisabled Individuals<strong>Part</strong> VI: Pertains to Individuals Entitled to <strong>Medicare</strong>Based on ESRDMarch 201131Should I complete the <strong>MSP</strong>Q?If beneficiary is a <strong>Medicare</strong> Advantage (MA)member• Do not complete the <strong>MSP</strong>QIf beneficiary is not a MA member• Initial visit: Complete the <strong>MSP</strong>Q• Recommended that <strong>MSP</strong>Q is reviewed at leastevery 90 days and updated as necessaryMarch 201132Should I complete the <strong>MSP</strong>Q?Hospital Lab Services• If beneficiary is present, complete the <strong>MSP</strong>Q.• If beneficiary is not present, do not complete the <strong>MSP</strong>Q.Reference Labs• There is a “relaxed” policy for reference labs.• <strong>MSP</strong>Qs that are no older than sixty (60) calendar daysfrom the date of service may be used to bill <strong>Medicare</strong>.• Remember to keep an audit trail.March 20113311
Change language