The Following Instructions Apply to "Assigned" Claims Only
Suppliers are reminded that Item 29 of the CMS-1500 Claim Form or the electronic equivalent is to be completed with the "total amount the patient paid on the covered services only." Any beneficiary payment amount collected for the specific covered items submitted on the claim, (i.e., coinsurance and deductible) should be reflected with the claim submission. Suppliers should not report any money collected on non-covered items, upgraded items, or items expected to be denied as not reasonable and necessary with an ABN on file. In the event Medicare is the secondary payer, suppliers should not report any primary insurance payments in the "Amount Paid" field. Click here to read the complete story.