The Relationship to Medicare Field in Patient Coverage

 

 

The �Relationship to Medicare� field on the Patient Coverage screen ONLY applies to patients who have another insurance PRIMARY to Medicare. The purpose of this field is to explain the reason why Medicare is not primary for this patient.If Medicare is the Primary insurance, you may choose NONE for both Medicare and the Secondary.Do NOT use Supplemental for either Medicare OR the Secondary in either case.

 

The following is a list of options which should be used and a list of options which should not be used:

 

Version 7.0x Clients ---DO NOT USE � NO LONGER VALID

Primary Payor

Medigap

Employer Supplemental

Supplemental

 

Version 7.0x Clients---USE FOR THE CARRIER PRIMARY TO MEDICARE ONLY

Primary, Black Lung

Primary, Disabled Beneficiary under Age 65

Primary, End Stage Renal Disease

Primary, No Fault Insurance including Auto

Primary, Public Health Service or Other Federal Agency

Primary, Working Aged Beneficiary or Spouse with Employer Group Health Plan

Primary, Veterans Administration

Primary, Workers Compensation

 

Version 6.5 Clients ---DO NOT USE � NO LONGER VALID

Medigap

Employer Supplemental

Supplemental

 

Version 6.5 Clients---USE FOR THE CARRIER PRIMARY TO MEDICARE ONLY

Primary Payor

 

All PPM Version Clients---

 

USE FOR MEDICARE WHEN MEDICARE IS SECONDARY ONLY

None

 

The Policy Type field on the Medicare Carrier (when Medicare is Secondary) should be:

�Medicare Conditionally Primary�