What You Should Know About Medicare Secondary Payer (MSP) Services

According to the U.S. Centers for Medicare & Medicaid Services , Medicare Secondary Payer (MSP) generally refers to circumstances or situations where Medicare is not primarily responsible for the payment of an individual’s healthcare needs and costs. Another entity bears the responsibility for paying for all claims, the most common being employer-sponsored group healthcare plans whether the individual’s coverage is for being an employee themselves or as a dependent spouse or child of an employee. Under U.S. federal laws and regulations Medicare is always a secondary payer for currently-employed individuals under an employer with more than 20 active employees.

Medicare Secondary Payer provisions also apply to Workers’ Comp Insurance. An individual who is primarily covered under Workers Compensation for health care services related to job-related injury claims is also entitled to Medicare. If a part of a claim is not covered by workers’ compensation, Medicare can pay for that part of the claim if it is eligible.

Navigating through Medicare Secondary Payer compliance is complex and tedious. The beneficiaries, hospitals, physicians, suppliers and employers have numerous responsibilities including responding to claims development letters in a timely manner, regularly updating changes in employment and health insurance coverages, obtaining updated billing information, following proper claim rules, submission of electronic claims, ensuring healthcare plans are updated and covers all employees and many more. This is where a Medicare Secondary Payer (MSP) services company comes in. These experts will resolve all the most difficult MSP compliance issues for your company.

By hiring a Medicare Secondary Payer services company, employers can benefit from complete Medicare-related solutions such as conditional payment resolution and Medicare Set Aside (MSA) allocations, which are Medicare-compliant allocations that projects injury-related Medicare-covered medical treatment, services and prescription needs over the claimant’s life expectancy. All MSA’s are prepared by registered nurses, certified Medicare Set Aside consultants, as well as certified Life Care planners.

Medicare Secondary Payer services providers can close cases rapidly and compliantly for all beneficiaries at a very reasonable cost. They handle the entire process from reporting to resolving the claims payments. Employers and employees have peace of mind knowing that these cases are being handled by a team of experts.

As a professional medicare secondary payer services provider, Novare offers a full line of compliance driven solutions accompanied with personalized service from receipt to resolution.  Our experts perform claim specific analysis and provide the right recommendations for cost saving solutions. Novare takes Medicare’s interest into account through the following: MSA Workers’ Comp and Liability, MSA Update and Submission, Medical Cost Projection (MCP), MCP to MSA Conversion and Update, Conditional Payment Identification, Dispute and Resolution, Final Document Submission and more.

Let us help you! Call us at 866.532.1929 today.