Creating MSP Claims
- Go to Billing > PPS Billing > Edit PPS Episodes and make sure that the episode hasn’t already had an EOE created (if so, cancel it). Now you can actually create the claim.
- Go to Billing > PPS Billing > Create EOE MSP Claims.
- As soon as you type the first 3 digits of the chart#, since there won’t be many, it’ll probably show up. If the name does not show up: Do the following verifications: a. Verify that the Medicare is second in the Referral > Payer screen; b. Make sure all visits in the episode have been changed to Medicare; c. Verify the RAP has already been created for the episode. The system will not generate the final (EOE) claim if the RAP has not been created.
- Select the episode.
- Fill in all the codes that are needed for the claim. If a payment was made, choose the correct value code and fill in the amount paid, and then type in the CAS line so that the amount paid + the amount adjusted = total amount billed (your charges, not the HIPPS code $Amount).
- Check Mark this episode as EOE created.
- Click the Create This One MSP Claim button. It’s ready to transmit.
Click here for MSP Billing tips.
***IMPORTANT: Palmetto offers an MSP Processing Tool that can help you determine your MSP claim outcomes.****
Because Barnestorm support thinks that this tool is a excellent, comprehensive, free resource for solving MSP issues,
we ask that you use this tool and its linked resources to attempt to answer your MSP question before calling Barnestorm.