Medicare as a Secondary Payer Questionnaire

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This page provides an integrated solution for the Medicare as a Secondary Payer Questionnaire. A link to this page appears at Check-in time for all patients with a Medicare policy.

 

On the Check-in page, in the Medicare secondary qualifier field, click Complete MSP questionnaire

 

 

 

 

Current laws and regulations require that all entities billing Medicare for services or items rendered to Medicare beneficiaries must determine whether Medicare is the primary or secondary payer for those services or items.

 

To meet this requirement, you can use the Medicare as a Secondary Payer Questionnaire in athenaOne. This eliminates paperwork and provides an audit trail showing who administered the questionnaire, when the information was gathered, and what data was captured.

 

 

Note: If you choose to use your current Medicare as a Secondary Payer Questionnaire workflow outside of athenaOne, you can still set the qualifier manually and ignore the Complete MSP questionnaire link.

  1. For a patient on Medicare, start the Check-in stage of an appointment.
  2. Medicare secondary qualifier — Click Complete MSP questionnaire to display the Medicare as a Secondary Payer Questionnaire page.
  3. On the Medicare as a Secondary Payer Questionnaire page, select all options that apply to this patient.
    As you click the relevant options, some of the statements and questions expand to display additional related options.
  4. Complete each field per the instructions on the page.
  5. Select who is answering the questionnaire (usually this is Self, meaning the patient).
  6. Proceed through each question until prompted to save your answers.
  7. Click Save.
  8. The Check-in page reappears.
  9. Medicare secondary qualifier — Select the qualifier, if necessary.
    Note: If the appointment is part of a treatment series, check the Appointment is part of a treatment series box. If you check this box, you can select the appointment with a completed MSPQ that should be associated with the ongoing series. The menu is populated with all appointments and relevant qualifiers completed within the past 90 days.

You can access the appointment audit on the View Patient Appointments page by clicking Audit history next to the MSPQ completed note.

 

 

 

  1. On the Quickview, in the Appointments heading, click View patient appointments.
    The View Patient Appointments page appears.
  2. In the list of appointments, find the appointment that includes the note "MSPQ completed" and click Audit history next to that note.
    The completed Medicare as a Secondary Payer Questionnaire appears.
  3. Click View printable questionnaire to display the questionnaire in a printable format.
  4. To print the questionnaire, click Print.

The department name and appointment ID appear at the top of the printable version of the MSPQ form. The department name and appointment ID come from the appointment that the MSPQ was completed for or associated with. This information is printed if a previously completed MSPQ is used with a different appointment (for example, an appointment series). If the MSPQ is not associated with an appointment, the department name and appointment ID fields are blank.

 

 

 

 

You can set up workflows to maximize compliance with CMS guidance regarding the Medicare as a Secondary Payer Questionnaire, and you can access a printable version of historic Medicare as a Secondary Payer Questionnaires via the claim and appointment history workflows. The goal is to determine correctly whether Medicare is the primary payer and, if it is the secondary payer, to arrive at the correct qualifier, which is required to bill any secondary claim to Medicare.

 

This workflow is optional. If your practice already has a solution that you prefer, you do not need to use this functionality. If you like the workflow, you can make it required using the MSPQ Settings page. To request that the fields on the form itself be required, please contact the CSC by selecting Support > Create Case or Call in the Main Menu.

 

athenaOne retrieves the patient's active insurance packages from the Quickview and the patient's employment information, active insurance packages, and active case policies from the Patient Registration page. In the Medicare as a Secondary Payer Questionnaire, this insurance and employment information is available for you to select in the relevant lists.

 

 

The MSPQ Settings page allows you to administer your practice's Medicare as a Secondary Payer Questionnaire (MSPQ). Using this page, you can create groups of MSPQ settings that you can apply to provider groups and departments.

 

Note: You no longer need to contact athenahealth to request practice setting updates for MSPQ. If your practice already has MSPQ settings enabled, you should see no change in MSPQ functionality.

 

 

 

You can require that an MSPQ be completed in athenaOne to select a Medicare Secondary Qualifier for an appointment.

 

When this feature is enabled, the Medicare Secondary Qualifier field on the Check-in page can be updated only by completing a questionnaire or by selecting a previously completed questionnaire via a treatment series.

 

You can also enable an additional qualifier option ("Medicare is Primary") for use when Medicare should be the primary insurance. This qualifier option is for reporting purposes only and is not printed on claims. With this option, you can require that the MSPQ be completed for all Medicare patients, which helps to ensure that claims are being filed with Medicare in the correct sequential order. When this feature is enabled, if the questionnaire determines that Medicare should be billed as the primary insurance, the "Medicare is Primary" option is automatically selected as the Medicare Secondary Qualifier.

 

To complete the MSPQ, click Complete MSP questionnaire (in the Medicare Secondary Qualifier field) on the Check-in page.

 

To enable these features, see the MSPQ Settings page.

 

 

 

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