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Administration Proposal February 14, 2020, MAP Response 2/21/20 Administration Response 2/28/20Template Memorandum of Understanding for Joint Appointments This Memorandum of Understanding, hereinafter
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MSP Response 22120 is a form used to report information regarding a Medicare Secondary Payer (MSP) situation where another payer is responsible for healthcare costs.
Entities such as group health plans or insurers that are involved in a Medicare Secondary Payer situation are required to file MSP Response 22120.
To fill out MSP Response 22120, you should accurately enter relevant information about the covered individuals, applicable insurance details, and other required data as instructed in the form guidelines.
The purpose of MSP Response 22120 is to provide necessary information to Medicare about other insurance coverage that may be primary to Medicare, ensuring proper coordination of benefits.
Information that must be reported on MSP Response 22120 includes the individual's name, Medicare number, insurer details, and specific coverage information relating to Medicare secondary payer situations.
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