1. Demystifying the MSP Rules Kevin Willis Director, Medicare Operations Claim Services Inc 46th Annual Educational Conference & Exhibition Patient Access: The First Connection to a Lasting Impression September 21 – 24, 2014

2. Medicare Secondary Payer (MSP) Questionnaire Must contain the correct answers! Must come from a valid resource It is a tool

3. Medicare Questionnaire Worker’s Compensation Black Lung Department of Veterans Affairs Government Grants

4. Accidents ( Non-Work Related) Automobile Slip and Fall Product Liability Dog Bites Good Will

5. No-Fault Insurance Is what it says, “no fault” Medical money only! Policy limits are present Policy parameters are applicable

6. Liability Do you hold anyone responsible? Liability is determined by the patient Pursuit of dollars is required Can be multiple responsible parties

7. Entitlement Age Disability ESRD Dual Entitlement

8. Age Entitled Medicare entitlement, beginning of month patient turns 65. 20 or more employees Spouse only Retirement dates defaults

9. Disability 100 or more employees Family member of any kind Retirement date equals last date worked COBRA coverage…

10. End Stage Renal Disease 30 month coordination period Employment data is irrelevant Dual entitlement Coverage can term, it just can’t be secondary

11. Group Health Plans Beware the patient preference rule Just because they pay, doesn’t mean they should Medicare’s rules trump everyone else’s

12. Medicare Audits Accidents are big ticket Improper entitlement identification ESRD patients Understand the questions you ask

13. Questions?