Healthcare providers must submit their Medicare Secondary Payer (MSP) claims electronically unless they meet one of the following exceptions:

1. Providers with fewer than 10 full-time equivalent employees.
2. Dentists.
3. Participants in a Medicare demonstration project when paper claim filing is required by that demonstration project due to the inability of the applicable implementation guide adopted under HIPAA to report data essential for the demonstration.
4. Providers that conduct mass immunizations, such as flu injections, that may be permitted to submit paper roster bills.
5. Providers that submit claims when more than one other payer is responsible for payment prior to Medicare payment (This applies when Medicare is at least the tertiary payer).
6. Providers that only furnish services outside of the United States.
7. Providers experiencing a disruption in electricity and communication connection that is outside of their control.
8. Providers that can establish an "unusual circumstance" exists that precludes submission of claims electronically.

If you qualify to continue filing hard copy claims and there is MSP involvement, please remember the following:

1. Your claim must be filed on an original CMS 1500 form and should be completed in dark black ink.
2. The Primary Insurer Explanation of Benefits must accompany the claim.
   1. Do not hi-light anything on the EOB.
   2. Do not put the primary insurer paid amount in field 29 of the claim form.
   3. The primary EOB must be clearly legible. If it is not legible, the claim will be denied.
   4. The primary EOB should clearly indicate the billed amount, allowed amount and or discounted amount and paid amount. It should also indicate whether or not you are under a contractual agreement with the primary insurer. If a primary EOB lacks any of the above information, it could result in an incorrect secondary payment or denial of the claim.
   5. If the claim was denied by the primary insurer, the remark code explanation for the denial must be clearly legible.
      1. If the remarks codes appear on a separate page, please also submit the remarks code page.
      2. If the remarks codes are on the back of the EOB, please copy the back and submit it as a separate page. The OCR Scanners do not copy front and back of an EOB.
   6. Send CMS 1500 claim forms directly to the claims filing address for your state which can be found on the contact section of the Medicare web sites.
      1. Sending claims to the incorrect address will delay the processing of your claim.

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