Obtaining Information to Determine Whether to Bill Medicare or

20 - Obtaining Information to Determine Whether to Bill Medicare or Another Payer (Rev. 1, 10-01-03) HO-300, SNF-401 The provider must ascertain whether the patient is a member of a Medicare + Choice organization (M+CO). If the patient is a member of an M+CO, the provider must contact the M+CO specified by the patient or identified on the patient’s membership card, so the provider may determine whether to submit the claim to the M+CO. If the patient indicates that he/she is not a member of an M+CO, the provider, in order to determine whom to bill, develops for situations where Medicare is the secondary payer by obtaining answers to the “Admission Questions to Ask Medicare Beneficiaries” contained in Chapter 3 of the Medicare Secondary Payer Manual. If another insurer is identified as primary to Medicare, the provider follows the procedures in the Medicare Secondary Payer (MSP) Manual.