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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
    • Display For Form Locator 4, If Not Primary Guarantor
    • Display For Form Locator 7
    • Display For Form Locator 9, If Medigap Benefits Are Assigned
    • Display For Form Locator 9, If No Medigap Benefits Are Assigned
    • Display For Form Locator 10-D
    • Display For Form Locator 11, If Primary Guarantor

'N' disables the above functionality.