Medicare as a Second Payer (MSP) Exam Questions & Answers 100% Accurate

What are the 3 ways someone is entitled to Medicare? - ANSWER-Age (65), disability, or End Stage Renal Disease Department of Veterans Affairs - ANSWER-If they have authorized and agreed to pay for services, then they will be primary and Medicare will be secondary. Workers Compensation - ANSWER-If the procedure is due to an illness/injury that is related to a work-related accident, then they will be the primary and Medicare will be the secondary. If the patient returns for something unrelated to the work-related illness/injury, then Medicare will be primary. Failure to comply with MSP provisions could result in - ANSWER-Civil and criminal penalties, except imprisonment. How is Medicare Primary based on disability? - ANSWER-If they are disabled and covered by a GHP through his or her own current employment, or through a family member's current employment. The employer must have less than 100 employees for Medicare to be primary. If the patient is age 65 or older and is covered by a Group Health Plan through current employment or spouse's current employment (employer has less than 20 employees), who is primary and secondary? - ANSWER-Primary: Medicare. Secondary: Group Health Plan. If the patient is age 65 or older and covered by a Group Health Plan through current employment or spouse's current employment (employment has >20 employees), who is primary and secondary? - ANSWER-Primary Group Health Plan. Secondary: Medicare.