myCGS

Eligibility

MSP

The "MSP" sub-tab is populated if the beneficiary has a payer that process claims primary to Medicare. This sub-tab displays only active MSP data and will not be listed if there is no MSP data or if notification of coverage primary to Medicare has not been received by CMS.

NOTE: If a date range is entered on the "Inquiry" screen, it will affect the MSP data returned.

Screenshot

The table below describes the "MSP" sub-tab fields:

Field Name Description

Maintenance Date

The date maintenance was last performed on the record

Patient Relationship

Identifies if the patient is the actual insured

Group Number

Identifies the MSP Insurance Group Number or the MSP Date of Loss.

  • If the returned value is a series of zeroes, the group number is not available
  • If number begins with ‘DOL’ this is the Date of Loss.

Policy Number

The primary insuring organization's policy number for the Medicare beneficiary

Effective Date

The start date of the primary insurer's coverage

Termination Date

The termination date of the primary insurer's coverage. No date in this field means primary insurance coverage has not terminated.

Type of Primary Insurance

12 = Medicare Secondary – Working aged beneficiary or spouse with employer group health plan
13 = Medicare Secondary – End-stage Renal Disease beneficiary in the 12-month coordination period with an employer group health plan
14 = Medicare Secondary – No-Fault insurance, including auto is primary
15 = Medicare Secondary – Workers' Compensation
16 = Medicare Secondary – Public Health Service (PHS) or other Federal Agency
41 = Medicare Secondary – Black Lung
42 = Medicare Secondary – Veteran's Administration
43 = Medicare Secondary – Disabled beneficiary under age 65 with large group health plan
47 = Medicare Secondary – Other liability insurance is primary
WC = Workers' Compensation Medicare Set-aside Arrangement

Diagnosis Codes

Lists specific diagnosis codes associated with MSP insurance types, such as Workers' Compensation (WC), automobile, and liability situations. If the patient has MSP records based on diagnoses, the specific ICD-10 codes will display for your reference.

Address

The address line 1 of the insurance company

Address 2

The address line 2 of the insurance company

City

The city of the insurance company

State

The state of the insurance company

ZIP Code

The ZIP code of the insurance company

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