Medicare Secondary Payer (MSP) Line Level Calculator
Calculate the line-by-line claim payment for covered services when Medicare is the secondary payer (MSP) by following the instructions below.
Instructions:
- Enter the appropriate values in each of the green fields. The blue fields will calculate automatically.
- In the Obligated to Accept (OTA) field, enter "Y" (for "yes") if the supplier is obligated to accept the primary insurer's allowed amount as payment in full. Otherwise, enter N (for "no"), or leave the field as is. For an explanation of OTA, see Chapter 11 of the Supplier Manual.
- 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.
Note: If the amount in the Medicare Secondary Payment is negative, please review the primary EOB to verify amounts are correct.