Submit Data to CWF When Partial Payment Made by Primary

40.8.12 - Submit Data to CWF When Partial Payment Made by Primary Payer (Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22) A/B MACs (Part A) submit data concerning the patient's utilization days, deductible, coinsurance amounts and MSP payment amounts to CWF. Utilization days used and deductible and coinsurance amounts satisfied are determined in the MSP payment modules after calculation of the Medicare payment amount. The "Utilization Days" field of the CWF Record contains the days to be charged to the beneficiary's Medicare utilization record as determined above. The "Value Code" fields of the CWF Record identify the coinsurance and amount charged the beneficiary as well as an MSP type of primary payer and the primary payer amount. Value code 44 and the amount are entered on the CWF Record in the appropriate fields (see CWF Documentation). Value code 44 indicates the amount the provider is obligated to accept as payment in full from the primary payer and this amount is greater than the amount paid by the primary payer for Medicare covered services entered by the provider in the identifying primary payer value code. For the PS&R, the A/B MAC (Part A) records the primary payment amount minus any deductible or coinsurance amounts.