What is the main purpose of the Medicare Secondary Payer MSP questionnaire?


Editorial team Published on

The purpose of the Medicare Secondary Payer (MSP) questionnaire is to find out if a patient has other health insurance or a separate program that is legally responsible for paying their medical bills before Medicare.

Why the Questionnaire Matters

  • Identifies Primary Payers: It determines whether another entity—such as a group health plan from an employer, workers' compensation, black lung program, or liability insurance—must pay the claim first.
  • Protects Medicare Funds: It ensures Medicare only pays as a secondary or tertiary payer when another insurance option exists, which saves the federal program billions of dollars each year.
  • Prevents Claim Denials: Healthcare providers use it to collect accurate billing data so claims are sent to the correct insurance company first, avoiding delayed or denied payments.
  • Federal Rule: The Centers for Medicare & Medicaid Services (CMS) requires providers to gather this information and keep the records on file for 10 years.