Medical Billing Forum

Billing => Facility Billing => : mizstafford May 13, 2015, 01:24:55 PM

: medicare-prim & bcbs-secon (facility billing)
: mizstafford May 13, 2015, 01:24:55 PM

Please help!!


Trying to bill Medicare coins to bcbs of mich. What value code is required to report Medicare's payment and the co-ins amount??

Thanks
Mizstafford

: Re: medicare-prim & bcbs-secon (facility billing)
: PMRNC May 13, 2015, 06:50:09 PM

What do you mean by value code? If there was no crossover then you would bill the secondary with the Medicare EOMB.. how they pay depends on various things.

: Re: medicare-prim & bcbs-secon (facility billing)
: mizstafford May 14, 2015, 10:53:50 AM

Morning Linda!

These are for claims that didn't crossover from Medicare to bcbs that I have to manually enter for bcbs of mich. The value codes are the codes used to show what Medicare paid and what is the secondary liability for the coins or deductible.  I know that these are the codes used I'm just trying to figure out in what order they go in fields 39-41 on the UB04.

A1=ded payor A
B1=ded payor B
C1=ded payor C

A2=coins payor A
B2=coins payor B
C2=coins payor C

A3=estimated responsibility payer A
B3=estimated responsibility payer B
C3=estimated responsibility payer C

I sent a claim to bcbs and it denied, when I called they said it was missing the value code for Medicare's payment. When I billed the claim in field 39a I had B3 and the coins $$ then in field 40a I had 80 and the # of units billed.

Hope this is a better explanation...

Thank you,

Mizstafford