The services are for treatment of a work-related illness or injury covered by work- ers' compensation or federal black lung benefits. No-fault insurance or liability insurance covers the services, such as those for ill ness or injury resulting from an automobile accident. A patient with end-stage renal disease is covered by an employer's group health plan. In this case, Medicare is the secondary payer for the first eighteen months. 1. Ron Polonsky is a seventy-one-year-old retired distribution manager. He and his wife Sandra live in Lincoln, Nebraska. Sandra is fifty-seven and is employed as a high-school science teacher. She has family coverage through a group health insurance plan offered by the state of Nebraska. Ron is covered as a dependent on her plan. The Medicare Part B carrier for Nebraska is the regional MAC. Which carrier is Ron's primary insurance carrier? Why? 6 Claim Completion ysicians who treat Medicare beneficiaries must file claims for their patients eve hey do not participate and do not accept assignment on the claims. CMS man es electronic transmission of Medicare claims using the HIPAA 837 forma ept by very small practices. mely Filing dicare law sets specific guidelines for timely filing of claims for benefits. TI alth reform law (Patient Protection and Affordable Care Act, or PPACA) requir hange in Medicare timely filing of claims for Part B providers. Previously, Me e law required the claim to be filed no later than the end of the calendar ye lowing the year in which the service was furnished. The new law requires clair be filed within one calendar year after the date of service. When filing a la