Thursday, October 28, 2010

Updated information on Medicare primary payment notice process from BCBSNC

On October 22, Blue Cross Blue Shield of North Carolina (BCBSNC) added clarifying information to their September 10th Employer News Article on the Medicare Primary Payment Notice (PPN).

Specifically, BCBSNC updated their answer to the following question:
What will occur if employers do not complete and return the PPN worksheets to MSRPC?

If you do not complete and return the worksheet to the MSPRC within 45 days of the issue date of the letter, a demand (referred to as a Medicare Secondary Payer demand) will be sent for repayment for all of the claims associated with the beneficiaries and corresponding coverage dates identified in this notice. If the MSPRC does not receive the correct coverage information from employers or BCBSNC, then the Medicare Secondary Payment (MSP) demands that are issued may be incorrect. You can avoid having to submit multiple valid documented defenses by correcting errors on the PPN.

Please be aware that an MSP demand may be issued regardless of whether or not a PPN worksheet is submitted by BCBSNC or the employer. The purpose of the PPN is to verify eligibility and coverage. In some cases, Medicare beneficiaries are covered under types of policies (such as retiree, COBRA or long term disability policies) where Medicare is still considered the "primary" payer. In other cases, Medicare beneficiaries are covered under types of policies where Medicare is not the "primary" payer. The PPN process is intended to improve the accuracy of Medicare Secondary Payer (MSP) demands, rather than to eliminate them.

For more information, please see our original August 31st post on this topic, the MSPRC Presentation or the Sample PPN.

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