Medicare organ if Medicare pays secondary?

[Guest guest]

When the hospital adds Medicare as secondary insurance, do you count this as a

Medicare organ for cost report reimbursement purposes regardless of whether

Medicare actually makes a secondary insurance payment on the account?

Our organization was informed by our intermediary that we cannot add the organ

as a Medicare organ on the cost report unless Medicare pays more than the

primary insurance. As this would be unlikely to happen, I don't see how a

patient with Medicare as secondary insurance could be counted as a Medicare

organ.

Drewis

Iowa Methodist Medical Center

[Guest guest]

Hi ,It can be counted only if the contract with the primary payer is NOT a paid in full contract and the amount paid by the primary payer is less than the Medicare Liability and that Medicare was billed. The primary problem that hospitals are having is the Paid in Full language in the contract, the next is the billing to Medicare and the last is the computation of the Medicare Liability. The amount paid by the claims office has no effect because the claims office pays NOTHING for the organ acquisition. Also, just because Medicare is in second place does not mean that it is automatically a Medicare organ on the Cost Report. Hope this helps,Thanks,Bill From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Sent: Friday, October 28, 2011 11:55 AMTo: TxFinancialCoordinators Subject: " Medicare organ " if Medicare pays secondary? When the hospital adds Medicare as secondary insurance, do you count this as a Medicare organ for cost report reimbursement purposes regardless of whether Medicare actually makes a secondary insurance payment on the account? Our organization was informed by our intermediary that we cannot add the organ as a Medicare organ on the cost report unless Medicare pays more than the primary insurance. As this would be unlikely to happen, I don't see how a patient with Medicare as secondary insurance could be counted as a Medicare organ. DrewisIowa Methodist Medical CenterNo virus found in this message.Checked by AVG - www.avg.comVersion: 2012.0.1834 / Virus Database: 2092/4580 - Release Date: 10/28/11No virus found in this message.Checked by AVG - www.avg.comVersion: 2012.0.1834 / Virus Database: 2092/4580 - Release Date: 10/28/11