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Printed Date: 9/22/2015
The Administrative Simplification Compliance Act (ASCA) requires that claims be submitted to Medicare electronically with few exceptions. MSP claims are not an exception unless there is more than one primary payer to Medicare.
Complete information about submitting electronic MSP claims is included in the "837 version of the 5010A1 Professional Implementation Guide." Follow the instructions in the following table for submitting MSP information electronically.
It is important that the primary payer paid amount and the remaining patient liability be entered so that the correct secondary payment is made. If the amounts are entered incorrectly, this could cause overpayments to be made. If it comes to the attention of Medicare that information was entered inaccurately and an overpayment has occurred, Medicare will request a refund of the overpayment amount.
Reference: The Implementation Guide is available on the ASC X12 website.
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Last Updated: 03/28/2019