Medicare as Secondary Payer Topics Page
Medicare is not always the primary insurance payer. As such, they review claims to see when they inappropriately paid as the primary payer when they should have been the secondary. It is essential for providers to clearly establish the Medicare status of a patient on the initial encounter and reviewed annually.
See Chapter 2 - Medicare in Find-A-Code's specialty-specific Reimbursement Guides or the ChiroCode DeskBook for more information about this important topic. Additionally, FindACode has created a Medicare Status Questionnaire Form (see "Resources/Links" tab) which is completed by the patient and helps to establish which payer is primary.
Resources
Select the title to see a summary and a link to the full article. some articles require a subscription to view.
by Aimee L. Wilcox, CPMA, CCS-P, CST, MA, MT
Billing with a GP Modifier
by Wyn Staheli, Director of Content - innoviHealth
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