Corporate
CGS Administrators, LLC

Serving the states of AL, AR, CO, FL, GA, LA, MS, NM, NC, OK, SC, TN, TX, VA, WV and the U.S. territories Puerto Rico and the Virgin Islands

MSP Line Level Calculator

CALCULATION INSTRUCTIONS

Enter the appropriate values in each of the green fields. The blue fields will calculate automatically.

In the Obligated to Accept (OTA) field, enter Yes (or Y) if the supplier is obligated to accept the primary insurer's allowed amount as payment in full. Otherwise, enter N (or leave the field as is). For an explanation of OTA, see below.

NOTE: If the primary paid amount is zero, then the supplier is not obligated to accept; the calculator does take this into account (you must enter $0.00 in the Primary Payment Amount)

Once you have entered all of the appropriate values, press ENTER on your keyboard.

For an explanation of this MSP calculation, please see Chapter 11 of the Supplier Manual.

Note: If the amount in the Medicare Secondary Payment is negative, please review the primary EOB to verify amounts are correct

Medicare Allowed Amount Medicare Deductible Applied Primary Allowed Amount OTA? Primary Payment Amount Medicare Secondary Payment
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Total

Explanation of Obligated to Accept (OTA)

Obligated to Accept (OTA) is a term used when a supplier has a contractual agreement to accept the primary insurance's allowed amount as payment in full (similar to accepting assignment). See the MSP Page for more information. 

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