Medicare billing update

Claims Submission Tips

The Medicare claims department has compiled a list of claims submission tips to address frequent problems they encounter when processing claims.

Medicare Secondary Payer (MSP) Claims

· If you are an electronic biller, please submit MSP claims electronically instead of submitting as paper.
· If you submit MSP claims on the 1500 Claim Form, ensure the correct primary insurance statement is attached and legible.
· When submitting a paper MSP claim, do not highlight the names on the primary insurance statement. It is acceptable to circle the names, but highlighting makes the statement difficult to read.

General Information

· Remember to submit documentation when billing the 22, 52 and 53 modifiers (except when reporting the 52 or 53 modifier on radiology services – a brief statement in Item 19 is acceptable).
· Claims containing the 55 modifier should indicate the range of dates.
· Provider signatures should be included on the claim form. If the signature is on file, "Signature on File" and/or a computer-generated signature are acceptable.
· Include CLIA numbers on the claim form when submitting lab tests.

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