Medicare Secondary Payer issues are among the top reasons for claim denials, claims 'returned as unprocessable,' and calls to Palmetto GBA. Use the
Palmetto GBA MSP Lookup Lookup tool to determine whether Medicare should be the primary or secondary insurer for your patients. This tool allows you to find the answer quickly and easily, before filing a claim. Simply answer a series of electronic yes/no questions to determine whether Medicare should be primary or secondary for that individual. This tool is located on the home page for Ohio, South Carolina Part B and West Virginia. You need only select the tool above to begin.
Because the determination of whether Medicare is primary or secondary is based on a number of federal laws, it can be confusing for patients and health care providers. The tool is designed to be completed online, uses no Protected Health Information (PHI) and is printable for your records. If you have used the CMS MSP questionnaire, you will find that the questions are very similar but the format is greatly simplified. It is also all electronic. This tool includes instructions about what to do if the MSP tool 'results' and Medicare records do not match. This generally requires some action on the part of the patient.