Medicare Secondary Payer (MSP)

Prevent an MSP Rejection on a Medicare Primary Claim

Table of Contents

[Return to Top]

Prevent an MSP Rejection on a Medicare Primary Claim

If you submit a Medicare primary claim when there is other insurance primary for the beneficiary, you are likely to receive a claim rejection for MSP.

[Return to Top]

Step 1

You will need the beneficiary’s identifying information. Model Admission Questions to Ask Medicare Beneficiaries.

[Return to Top]

Step 2

Take note that any claims for nongroup health plans, such as workers’ compensation, automobile, and no-fault shall be submitted to the appropriate insurer responsible for the inquiries. See CMS’ Non-Group Health Plan Recovery web page.

Be aware, beneficiaries may be working and have a group health plan that’s primary to Medicare. See CMS’ Group Health Plan Recovery web page.

[Return to Top]

Step 3

Once you have the correct beneficiary MSP data, submit the Medicare claim as appropriate.

If your claim denies for MSP, you may submit a clerical error reopening to resolve it. Refer to Correct or Reopen a Claim due to a MSP-related Issue.

[Return to Top]

Related Content

Revised 10/25/2023

Helpful Resources

MSP Questionnaire Example

Helpful Resources

BCRC Contact Information

Note: Providers should not call the BCRC to request they set up new or make corrections to existing MSP records. In addition to reporting such information on Medicare claims, when applicable providers may refer beneficiaries and other entities to the BCRC

BCRC Contact

1-855-798-2627

TTY/TDD: 1-855-797-2627

FAX: 405-869-3307