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Medicine, 03.03.2021 21:20 mluz

Review the following cases and determine the CMS-prescribed billing order for each. EXAMPLE: Example: Patient is retired and covered by Medicare, an employer-sponsored retirement plan, and his spouse’s employer-sponsored large group plan.

Billing Order: Employer-sponsored large group plan, Medicare, employer-sponsored retirement plan

1. Medicare as Secondary Payer: The patient has Medicare and an employer-sponsored retirement plan, and the patient is a dependent on the spouse's employer-sponsored large group plan. The claim is for an injury received in a car accident.

Billing order:

2. Medicare as Secondary Payer: The patient is 67, working full-time, and covered by Medicare, an employer-sponsored large group plan, and a Medigap plan. The spouse is retired, 62, and covered by an employer-sponsored plan for 18 employees.

Billing order:

3. Medicare as Secondary Payer: The patient is 50 and disabled and has Medicare and an employer-sponsored group health plan that covers 50 employees.

Billing order:

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