• Home
  • Medicare Secondary Payer (MSP) Worksheet - DIGITAL FORM

Medicare Secondary Payer (MSP) Worksheet - DIGITAL FORM

(0) No Reviews yet
$110.00
SKU: 3535E
$110.00

Updated form effective December 7, 2020  (CMS updated/streamlined from previous versions)

Electronically Delivered eForm* - Available Now – Subscribe Today!

Briggs Digital forms: 

-Updates included with annual subscription
-Form-fillable PDF documents at your fingertips
-Easy to complete on any device 


Providers are required to determine whether Medicare is a primary or secondary payer for every admission of a Medicare beneficiary as well as an outpatient encounter with a Medicare beneficiary prior to submitting a bill to Medicare. 

This worksheet identifies the questions that should be asked for every admission, outpatient encounter or start of care with exceptions provided.



Download a sample today!


License Agreement

Send completed License Agreements to CustomerSupport@BriggsCorp.com

*This this digital form is delivered as a form-fillable PDF and includes 1-year of updates.   To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery (please allow 2-3 business days for order fulfillment).  After 1- year, your update subscription will automatically renew.

Delivery:  Digital* 

Digital/electronic merchandise & subscriptions: all digital and electronic products and subscriptions are non-refundable and non-returnable. 


*This this digital form is delivered as a form-fillable PDF and includes 1-year of updates.   To receive your electronic file and updates you must complete and return a content license agreement and provide an end-user email address and contact name for file delivery (please allow 2-3 business days for order fulfillment).  After 1- year, your update subscription will automatically renew.

 

Ratings & Reviews

No reviews available

Be the first to Write a Review