tci Medicare Compliance & Reimbursement - 2018 Issue 8

Determine Medicare or Private Payer with This Handy Chart

Tip: Check for dual-eligibility. There are a plethora of patient circumstances that impact whether Medicare is primary or secondary, but the following are among the most prevalent you may encounter, according to CGS Medicare's Vanessa Williams, who spoke during the Part B payer's March 21 webinar, "Medicare Secondary Payer: The Basics." Follow the first chart to find out when Medicare is typically primary, and use the second chart to determine when Medicare is usually the secondary insurer. MEDICARE IS PRIMARY: Patient is age 65 or older and covered by both Medicare and a group health plan for an...

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