Medicare Secondary Payer (MSP) Electronic Claim Filing Frequently Asked Questions (FAQs)

The Electronic Data Interchange (EDI) area has been receiving many calls regarding the change that was made requiring MSP claims to be filed electronically. Therefore, we have compiled this list of FAQs to help the provider community.

1) If we have never sent claims electronically, how do we get set up to do so?
The first step a provider would need to do in order to send claims electronically is to register for a WPS Submitter ID. This Submitter ID is used within the electronic file to identify who is sending the file. You can register for a Submitter ID on our Website external link. If you currently receive your remittance advices electronically, registration is not necessary. Fax an EDI form to WPS at 402-351-6188.

2) Is dialing through a modem the only way to send an electronic file?
No. Your connectivity options are:

  • Bulletin Board System (BBS)
  • Use of connectivity vendor: IVANs or Vision Share.
  • Clearinghouses or billing service

3) Is there a free software program available to create our claims, or would we have to purchase one?
We do offer free billing software called PC-Ace Pro 32. The software and a users guide can be downloaded from the WPS EDI Website external link.

4) Can the PC-Ace program be used to transmit claims electronically?
No. The PC-Ace program can only be used to create the electronic claim file. It cannot send the file for you.

5) If we already create electronic claim files using a vendor software, do we have to use the PC-Ace software for our MSP claims?
No. If you are already using a vendor software to create your claims electronically, you can use that software for your MSP claims unless they are not set up to create MSP claims.

6) Can the PC-Ace software be used to correct claims that are in a Return to Provider (RTP) location?
No. In order to correct claims in the RTP location, you will have to contact the MSP area at 866-734-1521, and they will make the corrections for you.

7) If we use a clearinghouse to submit our Medicare primary claims electronically, can they also submit our MSP claims?
Yes. If you use a clearinghouse to submit Medicare primary claims, the clearinghouse can also be used to submit MSP claims.

Page Last Updated: Thursday, 18-Mar-2010 05:49:21 CDT