Submission of Medicare Secondary Payer (MSP) Claims

As of October 5, 2009, WPS Medicare will no longer be able to accept MSP claims (including conditional payment claims) that are submitted via Fiscal Intermediary Standard System Direct Data Entry (FISS/DDE). All MSP claim submissions will need to be submitted either electronically hardcopy submission on a UB-04 (CMS-1450) claim form*, or through PC-ACE. MSP adjustments must be submitted via EMC, hardcopy or through PC-ACE.

In addition, providers will not be able to correct MSP claims in FISS/DDE. If an MSP claim is returned to you (in status/location TB9997) for a correction, and you know the correction needing to be made, as a temporary solution, you may contact our MSP Representatives at 1-866-734-1521 to make the needed change.

How does this affect you?

  • If you submitted your MSP claim/adjustment through DDE on or after 10/05/09 it will edit with reason code 31265 and will be returned to you (RTP'd). WPS Medicare cannot process the DDE submitted claim/adjustment. You need to re-bill your claim through your EMC biller, hardcopy (if applicable) or through PC-ACE. MSP adjustments must be submitted via EMC, hardcopy or through PC-ACE.
  • If you submitted your MSP claim/adjustment through your EMC biller, hardcopy (if applicable) or through PC-ACE and it hits an MSP edit, you will need to call our MSP Representatives at the number above and provide the correction needed.

This change is the result of the implementation of Transmittal 70, Change Request (CR) 6426 titled "Instructions on Utilizing 837 Institutional CAS segments for Medicare Secondary Payer (MSP) Part A Claims." adobe portable format

Providers should contact their software vendor with any questions regarding the electronic submission of MSP claims. Information on Electronic Data Interchange (EDI) may be found on the WPS EDI Website external link.

* Hardcopy claim submission applies to you if you are a small provider (25 employees or less) or have a hardcopy claim waiver.

If you should have any further questions, please call our Provider Contact Center at the number listed below.

Region Provider Contact Center
Northeast 866-580-5945
Southeast 866-580-5981
Central 866-580-5984
West 866-580-5987

Page Last Updated: Thursday, 18-Mar-2010 05:48:54 CDT