Respuesta :
When the medicare program does not have primary responsibility for paying a beneficiary’s medical expenses, the medicare (D) secondary payer concept applies.
What is the secondary payer concept?
- When the Medicare program does not have a primary payment obligation - that is, when another entity pays before Medicare - the phrase "Medicare Secondary Payer" (MSP) is commonly used.
- A secondary payer is defined as a plan, insurance policy, or program that pays second on a medical care claim and only to the degree that payment has not been made.
- Depending on the circumstances, a secondary payer could be Medicare, Medicaid, or another type of insurance.
- When a person has a GHP through their own or a spouse's job and the employer has more than 20 employees, Medicare may be the secondary payer.
Therefore, when the medicare program does not have primary responsibility for paying a beneficiary’s medical expenses, the medicare (D) secondary payer concept applies.
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The question you are looking for is given here:
When the medicare program does not have primary responsibility for paying a beneficiary’s medical expenses, the medicare __________ concept applies.
a) limiting charge
b) conversion factor
c) balance billing
d) secondary payer
