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Author Question: If a beneficiary has both TRICARE Senior Prime/TFL and Medicare, which plan is primary? TRICARE ... (Read 100 times)

Awilson837

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on: Jun 27, 2018
If a beneficiary has both TRICARE Senior Prime/TFL and Medicare, which plan is primary?
 
  TRICARE is primary.
 
  Medicare is primary.
 
  The patient can select which is primary.
 
  The provider can select which is primary.

Question 2

How is reimbursement calculated for workers' compensation claims?
 
  What will be an ideal response?
Comprehensive Health Insurance: Billing, Coding, and Reimbursement ¦ Vines, Braceland, Rollins, Miller ¦ 3rd Edition
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ririgirl15

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Reply #1 on: Jun 27, 2018
Answer to Question 1

Answer: TRICARE is primary.

Answer to Question 2

Answer: When the workers' compensation policy is not a managed care plan, fees for services are based on the Medicare Fee Schedule (MFS); the MFS fee is multiplied by a certain percentage determined by each state to arrive at the billable fee.


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