Billing: CMS Clarifies Rules for Submitting Medicare Secondary Payer Claims

Why This Topic Matters

Medicare Secondary Payer claims are a frequent source of billing errors, delays, and denials when payer order or supporting documentation is incomplete. Understanding the CMS guidance helps practices improve claim accuracy and reduce avoidable rework.

Article Sections

1. CMS MSP billing tips

   An overview of CMS guidance for handling Medicare Secondary Payer claim submission issues in Part B practices. The section focuses on common billing workflow concerns and related CMS instructions.

2. Ask patients about all of their insurers

   Guidance on collecting insurance information from patients and confirming payer order before submitting claims. This section addresses how missing coverage information can affect claim handling.

3. Bill primary payer first, not simultaneously

   Discussion of the sequence for submitting claims when multiple payers are involved. The section addresses the general coordination-of-benefits process described by CMS.

4. Single out accident claims

   Coverage of claims involving liability, no-fault, or workers' compensation situations and the related Medicare Secondary Payer workflow. The section also notes the role of payer remittance information in claim processing.

5. Claims? Include EOB

   A brief reminder about documentation to include with paper claims when electronic billing is not used. The section references supporting payer information needed for submission.