Step 1: Review Your In-House Files to Identify the Information the BCRC Needs to Set Up the Beneficiary’s MSP Record
The BCRC requires information from you including but not limited to:
- the beneficiary’s name
- complete address
- HICN
- primary insurance company’s name and complete address, and
- the name of the insured
If the beneficiary’s insurance is through an employer, you need to provide the date the insurance became effective. If the beneficiary was involved in a workers compensation case or was in an accident, you need to provide the date of the injury/illness/accident.
Step 2: Contact the BCRC to Request They Set Up an MSP Record for the Beneficiary
You can reach the BCRC via phone, mail or fax. Refer to CMS’ Web page with the BCRC contact information you need.
You should have the beneficiary’s identifying information (from Step 1) available. The BCRC may request additional information to investigate the MSP situation and set up an MSP record for the beneficiary.
Step 3: Wait for the BCRC to Set Up the Open MSP Record for the Beneficiary
You will need to continue to check for the MSP record. To check Medicare’s records, you can use the provider self-service tools listed under Step 2 Determine If Medicare Is Primary or Secondary for a Beneficiary's Services. If the BCRC does not set up the MSP record, you must follow up with them.
Step 4: Once the MSP Record is Set Up, Submit the MSP (or Conditional) Claim to Medicare for the Beneficiary (if Applicable)
If you want to submit an MSP (or conditional claim) for a beneficiary’s services, you must ensure that there is an open matching MSP record for the beneficiary in Medicare’s records prior to submitting the claim. If there is no matching record, you must contact the BCRC to ask them to set one up.
Note: You must contact the BCRC, even if you do not want to submit a claim to Medicare, if you are made aware of an MSP situation for which there is no MSP record.
- If you need help preparing or submitting your MSP claim, refer to Prepare and Submit a Medicare Secondary Payer Claim.
- If you need help preparing or submitting your conditional claim, refer to Prepare and Submit an MSP Conditional Claim.
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