Medicare as Secondary Payer

Medicare requires specific information in order to process and pay paper claims when Medicare is considered the secondary payer.
Novitas Solutions, Medicare Area Contractor for Arkansas, Colorado, New Mexico, Oklahoma, Texas, Louisiana, Mississippi, Delaware, District of Columbia, Maryland, New Jersey, some counties in Virigina and Pennsylvania, provides details on documentation needed on the EOB for successful processing of claims and proper payment.  This informaiton is included in Chaper 11 of their Reference Manual.
  • Date of service
  • Name and address of the primary insurer
  • Name of provider of services
  • Name of subscriber and policy number
  • Itemized charges for all procedure codes reported
  • A detailed explanation of any denials or payment codes
Ensuring this information is submitted to Medicare in full, will ensure your cash flow stays fluid.