decisionhealth Newsletters, Part B News - 2003 Issue 7 (July)
Credit patient's Medicare deductible when program is secondary payer
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Article Overview
This article covers Medicare secondary payer billing, deductible crediting, and the relationship between a primary payer’s payment and Medicare’s allowable amount. It is relevant to billing staff, coders, and revenue cycle teams that handle claims involving Medicare as a secondary payer. The piece also references CMS guidance and a Medicare manual section to explain why zero-balance claims may still need to be submitted.
Why This Topic Matters
Understanding this topic helps staff process coordination-of-benefits situations correctly and avoid misunderstandings about how patient deductible credit is calculated when Medicare is secondary.
What You Will Learn
- How Medicare secondary payer situations affect deductible crediting
- Why deductible credit is tied to Medicare’s allowable amount rather than the primary payer’s payment
- Why zero-balance claims may still be submitted in certain Medicare billing situations
- How CMS guidance and Medicare manual language relate to this billing topic
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle professionals
- Practice managers
- Compliance staff
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