New Insurance Carrier (including self insurance) Reporting Requirements

Attorney   Responsibility

Provider Rules and Manner of Investigation

MSP Claims Worksheet

Duties of COB Contractor

NEW:   Expedited Process Being Established to Obtain Medicare Lien Information (Conditional Payments)

 

MSP

From CMS:

The Coordination of Benefits (COB) Contractor consolidates the activities that support the collection, management, and reporting of other insurance coverage for Medicare beneficiaries. The purposes of the COB program are to identify the health benefits available to a Medicare beneficiary and to coordinate the payment process to prevent mistaken payment of Medicare benefits. The COB Contractor does not process claims, nor does it handle any mistaken payment recoveries or claims specific inquiries. The Medicare intermediaries and carriers are responsible for processing claims submitted for primary or secondary payment. To resolve your questions regarding whom to contact, see below:

Contact the COB Contractor to:

  • Report employment changes, or any other insurance coverage information.
  • Report a liability, auto/no-fault, or workers compensation case.
  • Ask general Medicare Secondary Payer (MSP) questions/ concerns.
  • Ask questions regarding Medicare Secondary Development (MSP) letters and questionnaires.

Contact your local Medicare intermediary or carrier to:

  • Answer your questions regarding Medicare claim or service denials and adjustments.
  • Answer your questions concerning how to bill for payment.
  • Process claims for primary or secondary payment.
  • Accept the return of inappropriate Medicare payment.

Contact 1-800-MEDICARE (1-800-633-4227) to:

  • Obtain general Medicare information.
  • Obtain information about Medicare Health Plan choices.
  • Order Medicare publications.

Contact SSA to:

  • Enroll in the Medicare program.
  • Replace your Medicare card.
  • Change your address.
  • Verify Medicare coverage.

Jay J. Sangerman, PLLC
60 East 42nd Street - Suite  2218
New York, New York 10165
Telephone (212) 922-0711
Facsimile (212) 922-0709
jsangerman@sangerman.com

4115 NW 60th Circle
Boca Raton, Florida  33496
561-989-9095

Jay J. Sangerman & Associates
Lanidex Executive Center
100 Misty Lane
Parsippany, New Jersey 07054
(973) 739-9055

RETURN TO INDEX