Wednesday, April 9, 2008

How to complete MSP paper claims?

If your office is still dropping secondary paper claims to Medicare you will want to make sure you are sending them complete documentation.

1. A CMS - 1500 claim form

2. A legible copy of the primary Explanation of Benefits (EOB). Do not highlight anything on the EOB and do not put the primary insurer paid amount in fiel 29 of the claim form.

  • EOB should indicate the billed amount

  • EOB should indicate the allowed amount

  • EOB should indicate the paid amount

  • EOB should indicate if you are in network or out of network with the primary insurance carrier

3. If the claim was denied by the primary insurer, the remark code explanation for the denial must be included with documentation. If these remark codes are on the last page of the EOB or on the back of the EOB you will need to submit this information on a seperate page.

Medicare OCR scanners do not copy the front and back of the EOB's so it's possible that you may need to submit 3 pages of documentation to Medicare.

For those of you tired of dropping secondary claims to paper I would recommend the following:

1. Contact your software vendor and ask them if they can submit claims electronically for secondary insurance carriers


2. Contact your clearinghouse and verify they can submit secondary claims electronically.

Confused by Electronic Medical Claim billing then read these articles on Billing Health Insurance medical claims

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  1. i have been searching for a step by step guide on billing medicare as a secondary insurance. my medical program is medisoft v12

  2. Hi Brandi,

    I would first recommend you check out these other blog articles to see if this answers your questions on billing Medicare Secondary Claims Electronically -

    If these do not answer your questions please do me a favor and make another comment on my blog but this time leave me your email address. I will not release the email address or comment to the public but I will email you and see if I can help walk you through the necessary steps to get your Medisoft v12 to populate the correct format.

    I would also like to know what electronic claims Clearinghouse you are using to submit the elctronic file to or is this a direct connection with Medicare.

    We can talk in more detail about the specifics if you send me your email address.


  3. I am billing out of brightree and we are trying to figure out how to bill medicare secondary. We have WHAT we need to put on the CMS 1500, but the problem we are running into is what boxes on the form to put the information in. Suggestions or answers?

  4. My company I work for is billing out of Brightree and we are trying to figure out how to bill Medicare as Secondary. We have found out what we need to put on the CMS-1500 form, we just dont know in what boxes to put the information in. We dont want them getting denied. But we dont know what information goes where. Help?