Saturday, February 17, 2007

Billing Medicare Secondary Payor or MSP claims

If your office bills to Medicare a lot you may have run into a situation when a patient calls you and says that Medicare is requesting them to fill out a SCD form. SCD means Secondary Claim Development and it's a questionnaire form Medicare requires the patient to fill out prior to processing YOUR claim.

When or if Medicare receives a claim from the medical office with a primary EOB attached it "flags" them to request this information from the patient if this form is not on file at Medicare.

The issue for the medical billing office is now the claim is on a hold status until Medicare receives the SCD form back from the patient (NO MONEY). To resolve this issue train the front office to have a Medicare Secondary Payor (MSP)form on file and have the patient fill it out prior to treatment. This is only necessary if a patient presents with a second medical insurance card.

Have the front office scan this form into the patients chart files in the medical billing software you use so you will always be able to reference back to it (and not bother the doctors office in the process)

If you received a EOB stating it's pending or you get a call from the patient pull the document up from the patient chart files and rebill your claim with the attached SCD form or call Medicare and identify if you can fax or email it to them. When you return the SCD in a timely manner, you help ensure correct payment of your Medicare claims and that means a happy doctor.

If you have questions or concerns about the MSP form you can call medicare at: 1-800-999-1118 or TTY/TDD: 1-800-318-8782 for the hearing and speech impaired with. Medicare Representatives are available to assist you Monday through Friday, from 8:00 a.m. to 8:00 p.m., Eastern Time, except holidays (don't you wish we got those?).

**As a side note Medicare estimates that they have saved $4.5 billion dollars by using MSP codes.

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