Medicare Secondary Payer Manual (Pub. 100-05), Ch. 6 § 40.2

CWF Claim Matching Criteria Against MSP Records

Last amended: 2023Year: 2023Length: 64 wordsOfficial source
40.2 - CWF Claim Matching Criteria Against MSP Records (Rev. 12078; Issued:06-14-23; Effective: 05-29-23; Implementation: 05-29-23) The matching criteria between the claim and the MSP auxiliary occurrence in CWF is as follows: HICN/MBI, MSP type, MSP effective date and termination date, insurance type, patient relationship code and validity indicator for the same insurer. Note, NGHP records includes matching on the family of diagnosis codes.
Medicare Secondary Payer Manual (Pub. 100-05), Ch. 6 § 40.2: CWF Claim Matching Criteria Against MSP Records | Justis AI