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Enable Medigap Support - Registry Setting

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Avatar PM > System Maintenance > Guarantors/Payors

A Medigap policy fills "gaps" in Medicare coverage by providing payment for charges that Medicare may not be responsible for due to deductibles, coinsurance, or other limitations imposed by Medicare.

'Y' performs the following:

  • The following fields display in the Guarantors/Payors form:
    • Medigap Guarantor
      The Medigap Guarantor field displays in the Financial Eligibility, Cross Episode Financial Eligibility, and Family Financial Eligibility forms (Guarantor Selection section). When the guarantor is selected, if Medigap Guarantor is enabled (Guarantors/Payors form), this information populates and can be edited.
    • Policy Or Group Number Prefix (HCFA-1500)
    • Medigap Payer Id (HCFA-1500)
    • Medigap Insurer Address (HCFA-1500).
  • The following fields display in the Guarantor/Program Billing Defaults form (Paper CMS-1500 section):
    • Display For Form Locator 4, If Primary Guarantor
      Select the value to be entered in form locator 4 for the primary guarantor.
    • Display For Form Locator 4, If Not Primary Guarantor
      Select the value to be entered in form locator 4 if the guarantor is not the primary.
    • Display For Form Locator 7
      Select the value to be entered in form locator 9 for the insured.
    • Display For Form Locator 9, If Medigap Benefits Are Assigned
      Select the value to be entered in form locator 9, if the client has Medigap benefits.
    • Display For Form Locator 9, If No Medigap Benefits Are Assigned
      Select the value to be entered in form locator 9, if the client does not have Medigap benefits.
    • Display For Form Locator 10-D
      Select the value to be entered in form locator 10-D.
    • Display For Form Locator 11, If Primary Guarantor
      Select the value to be entered in form locator 11, if the guarantor is the primary.

'N' disables the above functionality.