MSP Provider, Physician, and Other Supplier Billing Requirements

30.2 – MSP Provider, Physician, and Other Supplier Billing Requirements (Rev. 11755, Issued:12-21-22, Effective: 01-23-23, Implementation: 01-23-23) Chapter 3 of the Medicare Secondary Payer Manual, an outline of the provider’s responsibility to gather information sufficient to identify primary payers and to bill them before billing Medicare, if MSP provisions state Medicare should be secondary payer. Identifying commensurable information upon beneficiary admission can help prevent incorrect billing and Medicare overpayments. A/B MACs, DME MACs and the MSP Contractors are required in professional and public relations activities to inform providers, physicians, other suppliers, and beneficiaries about the MSP provisions and that claims for services to beneficiaries for which Medicare is the secondary payer must be directed first to the primary plan where there is primary coverage for the services involved. The Medicare law and/or provider agreement require the submitter to identify on the claim all known payers obligated to pay primary to Medicare. See 42 CFR § 489.20.