Enter the appropriate values in each of the green fields. The blue fields will calculate automatically.
In the Obligated to Accept (OTA) field, enter Yes (or Y) if the supplier is obligated to accept the primary insurer's allowed amount as payment in full. Otherwise, enter N (or leave the field as is). For an explanation of OTA, see below.
NOTE: If the primary paid amount is zero, then the supplier is not obligated to accept; the calculator does take this into account (you must enter $0.00 in the Primary Payment Amount)
Once you have entered all of the appropriate values, press ENTER on your keyboard.
For an explanation of this MSP calculation, please see Chapter 11 of the Supplier Manual.
Note: If the amount in the Medicare Secondary Payment is negative, please review the primary EOB to verify amounts are correct