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Medicare Secondary Payer Worksheet 3535P

Medicare Secondary Payer (MSP) Worksheet

Item SKU # - 3535P
List Price: $11.80
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Complete this form on all Medicare eligible patients even if Medicare is not being billed. Do this at admission and as appropriate during the course of care. Each organization should determine what department/staff will procure and retain needed information.

Other uses for this form are to monitor and evaluate trends regarding primary versus secondary payers, educate staff about primary versus secondary payers and educate patient and caregiver about Medicare as secondary payer.


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