The Medicare term for money recovered by Medicare after the primary insurer pays is:

• A. Conditional Payment
• B. Refund
• C. Reimbursement
• D. Reserve

Answer: (A)

Medicare uses conditional payment when there is a possibility that another payer will be primary. Medicare pays first to cover the service, but the payment is labeled as conditional because it will be recouped if the primary payer ends up paying. Once the primary insurer pays, Medicare collects back that amount, which is why it’s described as money recovered through a conditional payment. The other terms don’t fit this scenario: refunds and reimbursements refer to returning money in different contexts, and a reserve isn’t the Medicare term for this process.