Provider Billing Where Services are Covered by a GHP

30.1 - Provider Billing Where Services are Covered by a GHP (Rev. 11874, Issued: 02-23-23, Effective: 03-24-23; Implementation: 03-24-23) Providers may seek reimbursement from a GHP insurer before billing Medicare when there is an indication the insurer is primary payer. A GHP is billed first as primary payer even where there may be primary coverage for only part of the stay or services (e.g., split stays where the beneficiary terminated employment during the stay and the GHP coverage terminated concurrently.) When a provider bills a GHP as primary payer, the bill itemizes the services rendered even though they are services for which Medicare reimburses on a fee schedule or other reimbursement methodology.