Correct a Beneficiary's MSP Record

Table of Contents

• Correct a Beneficiary's MSP Record
• Step 1: Identify the MSP Record for the Beneficiary on the CWF That Needs Correction
• Step 2: Submit a Medicare Primary Claim for the Beneficiary’s Services with the Information to Correct the MSP Record on the CWF.
• Step 3: Wait for Medicare to Contact the BCRC with the Corrected Information From Your Claim.
• Step 4: Check the CWF for the Beneficiary’s Corrected MSP Record.
• Step 5: Return Your Medicare Primary Claim Once the Beneficiary’s MSP Record is Corrected on the CWF.
• Related Content

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Correct a Beneficiary's MSP Record

• Fact: During your MSP screening process with the beneficiary, you may learn of information for a beneficiary that Medicare is not aware of which makes Medicare the primary payer for the beneficiary’s services. If this information conflicts with an MSP record on the CWF and that MSP record needs to be corrected, report it on your Medicare primary claim for the beneficiary.

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Step 1: Identify the MSP Record for the Beneficiary on the CWF That Needs Correction

You can check to determine if there’s a MSP record on the CWF using the provider self-service tools listed under Step 2 of Identify the Proper Order of Payers for a Beneficiary’s Services.

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Step 2: Submit a Medicare Primary Claim for the Beneficiary’s Services with the Information to Correct the MSP Record on the CWF

There are many reasons you may have determined the MSP record for the beneficiary on the CWF is incorrect and Medicare is the primary payer for the beneficiary’s services. In this situation, submit a Medicare primary claim and, on that claim, report the reason Medicare is the primary payer for the beneficiary’s services. To review the claim coding you can use to indicate the reason Medicare is the primary payer for the beneficiary’s services and why the MSP record for the beneficiary needs to be corrected, refer to Prevent a MSP Rejection on a Medicare Primary Claim.

Upon receipt of your Medicare primary claim, we review claim coding you reported to indicate the reason Medicare is the primary payer for the beneficiary’s services and why the MSP record for the beneficiary needs to be corrected. If appropriate, we contact the BCRC with the information from your claim so they can correct the applicable MSP record for the beneficiary on the CWF.

The BCRC reviews and, if necessary, investigates the new information. If appropriate, they correct the applicable MSP record for the beneficiary on the CWF.

Note: If there is no claim coding available to indicate the reason Medicare is the primary payer for the beneficiary’s services and why the MSP record for the beneficiary on the CWF needs to be corrected, do not contact the BCRC. Providers may refer beneficiaries and other entities to the BCRC.

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Step 3: Wait for Medicare to Contact the BCRC with the Corrected Information From Your Claim.

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Step 4: Check the CWF for the Beneficiary’s Corrected MSP Record.

Check using provider self-service tools listed under Step 2 of Identify the Proper Order of Payers for a Beneficiary’s Services.

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Step 5: Step 5: Return Your Medicare Primary Claim Once the Beneficiary’s MSP Record is Corrected on the CWF.

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Related Content

• CMS Benefits Coordination & Recovery Center (BCRC) contacts web page
• Identify the Proper Order of Payers for a Beneficiary’s Services
• Prevent an MSP Rejection on a Medicare Primary Claim

Revised 10/26/2023