Hospital Reviewer requested 40 claims per hospital with supporting documents:  UB04  MSP Admission Questionnaire  Beneficiary's Medicare Summary Notice (MSN)  Admission Policies that identify Other Payer primary to Medicare  Registration Policies that describe the process and systems used to meet compliance  Billing policies that identify Other Payer primary to Medicare and Medicare No Pay billing procedures  Medicare Secondary Payer Training Manuals and policies
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