The MSP tab is available when the insurance plan requires the completion of the Medicare Secondary Payer Questionnaire. This is routinely required when Medicare is the secondary insurance.

The Person Supplying Information section is required and identifies the person (patient, relative, caregiver, etc.) providing information, and the Medicare Secondary Payer Questions section contains a list of questions that are required by the government. The selections may determine the primary insurance or require additional information (Accident, Age, Disability, and ESRD).

To add MSP information, follow these steps:

1. Rel to Pat – Click the drop-down menu and select the relationship to the patient for the person supplying information. If the person is the patient or is someone who was entered into the Relatives list, their information automatically populates. If the person is not in the system, the remaining steps must be completed.
2. Last, First, and MI – Enter the person’s name information. The first and last name fields are required.
3. Phone – Enter the person’s phone number.
4. Check to select the following:
   • Per the Patient, Illness/Injury is covered by Worker’s Compensation Claim – Check if true.
   • Date of Illness/Injury – Click the field to enter the date directly or click to select a date from a calendar.
   • Patient is covered by Federal Black Lung Program – Check if true. When selected, the Federal Black Lung Program is the primary insurance.
   • Patient is covered by Government Research Program – Check if true. When selected, a government research program will pay the benefits.
   • Patient entitled to benefits through Department of Veterans Affairs (DVA) – Check if true. When selected, the If yes, has the DVA authorized and agreed to pay for care at this facility checkbox is enabled. Click the checkbox if the DVA has authorized and agreed on payment.
   • Services covered by a PHS, other than Medicare or Medicaid – Check if true. When selected, a government program will pay the primary benefits.
   • Services are a result of a non-work related accident – Check if true. The Medicare Secondary Payer – Accident tab is enabled. Complete the information requested in that tab. For more information, see Add/Update Medicare Secondary Payer – Accident Information.
   • Entitled to Medicare based on Age – Check if true. The Medicare Secondary Payer – Age tab is enabled. Complete the information requested in the window. For more information, see Add/Update Medicare Secondary Payer – Age Information.
   • Entitled to Medicare based on Disability other than ESRD – Check if true. The Medicare Secondary Payer – Disability tab is enabled. Complete the information requested in the window. For more information, see Add/Update Medicare Secondary Payer – Disability Information.
   • Entitled to Medicare based on ESRD – Check if true. The Medicare Secondary Payer – ESRD tab is enabled. Complete the information requested in the window. For more information, see Add/Update Medicare Secondary Payer – ESRD Information.
   • Patient never employed – Check if true.
   • Spouse never employed – Check if true.

5. Click Save.

Update MSP Information

MSP information can be updated. To update MSP information, follow these steps:

1. Make any necessary changes.
2. Click Save.

Add/Update MSP – Accident Information

The Medicare Secondary Payer – Accident window is enabled when the Services are a result of a non-work related accident option is checked on the Medicare Secondary Payer Questionnaire tab. The tab is used to add or update information specific to the accident.

To add or update information, follow these steps:

1. Type – Click the drop-down menu and select the type of accident that happened.
2. Location – Enter a location where the accident happened in the free-form text field.
3. State – Click the drop-down menu and select the state where the accident happened.
4. Country – Click the drop-down menu and select the country where the accident happened.
5. Date – Click the field to enter the date directly or click to select a date from a calendar.
6. Claim No – Enter the insurance claim number.
7. Covered by a Non-liability Insurance – Check if true.
8. Covered by a Liability Insurance or Other Responsible Party – Check if true.

9. Click Save.

Add/Update MSP – Age Information

The Medicare Secondary Payer – Age tab displays when the Entitled to Medicare based on Age option is checked on the Medicare Secondary Payer Questionnaire tab. The tab is used to add or update information regarding the patient and/or spouse.

To add or update information, follow these steps:

1. Patient is currently employed by an employer of 20 or more employees – Check if true. The Patient’s Retire Date deactivates.
2. Patient’s Retire Date – Click the field to enter the date directly or click to select a date from a calendar. This date will be populated in any blank retirement date fields throughout RCM Cloud^®. This field is active if the Patient is currently employed by an employer of 20 or more employees box is unchecked.
3. Spouse is currently employed by an employer of 20 or more employees – Check if true. The Spouse’s Employer ID field activates and the Spouse’s Retire Date deactivates.
4. Spouse’s Employer – Enter an employer code in the first field or an employer name in the autocomplete field (clicking a suggested description to select it). The Spouses’s Employer Name field automatically populates with employer name.
5. Spouse’s Retire Date – Click the field to enter the date directly or click to select a date from a calendar. This field is active if the Spouse is currently employed option is not checked. If retired, enter the date.
6. GHP coverage based on patient’s or spouse’s current employment status- Activates when one of the first two options is selected. Check if true.

7. Click Save.

Add/Update MSP – Disability Information

The Medicare Secondary Payer – Disability tab displays when the Entitled to Medicare based on Disability other than ESRD option is checked on the Medicare Secondary Payer Questionnaire tab. The tab is used to add or update information regarding the patient and/or family for a disability other than ESRD (End Stage Renal Disease).

To add or update information, follow these steps:

1. Patient is currently employed by an employer of 100 or more employees – Check if true.
2. Family member is currently employed by an employer of 100 or more employees – Check if true. The Family’s Employer field activates and the Family’s Retire Date deactivates.
3. Family’s Employer – Enter an employer code in the first field or an employer name in the autocomplete field (clicking a suggested description to select it).
4. Family’s Retire Date – Click the field to enter the date directly or click to select a date from a calendar. Field is active if spouse if the Family member is currently employed option is not checked.
5. GHP coverage based on patient’s or family’s current employment status – Activates when one of the first two options is selected. Check if true.

6. Click Save.

Add/Update MSP – ESRD Information

The Medicare Secondary Payer – ESRD tab displays when the Entitled to Medicare based on ESRD option is checked on the Medicare Secondary Payer Questionnaire tab. The tab is used to add or update information regarding the patient for ESRD (End Stage Renal Disease).

To add or update information, follow these steps:

1. Patient had a kidney transplant – Check if true. The Date of Transplant field activates.
2. Date of Transplant – Enabled if the Patient had a kidney transplant option is checked. Click the field to enter the date directly or click to select a date from a calendar.
3. Date of First Regular Dialysis – Click the field to enter the date directly or click to select a date from a calendar.
4. Date of Self Dialysis Training Program – Click the field to enter the date directly or click to select a date from a calendar.
5. Patient covered by a GHP through a current or former employer of any size – Check if true. The Patient within the 30-month coordination period checkbox activates.
6. Patient within the 30-month coordination period – Check if true. The Patient entitled to Medicare… checkbox activates.
7. Patient entitled to Medicare on the basis of either ESRD and age or ESRD and disability – Check if true. The final two checkboxes activate.
8. Patient’s initial entitlement to Medicare was based on ESRD – Check if true.
9. The working aged or MSP disability provision does apply – Check if true.

10. Click OK.