Author Topic: Medicare as Secondary  (Read 1499 times)

DMK

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Medicare as Secondary
« on: October 10, 2013, 11:12:25 AM »
I feel really dumb asking this question after years of billing BUT we have a new Part B carrier (Noridian) and I got an EOB back with $0 payment stating that "did not indicate whether we are the primary or secondary payer". 

The claim was sent with the primary eob attached and noted and highlighted on the claim "primary eob attached".

Have I been processing my secondary claims wrong all along?  Is there a way to show on a claim whether it's primary or secondary?

What would be the easiest way to re-process this?

I appreciate any input!




PMRNC

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Re: Medicare as Secondary
« Reply #1 on: October 10, 2013, 11:14:15 AM »
That's NOT a dumb question at all. With Medicare the PATIENT is responsible for all COB issues.. THEY have to send info to Medicare and get the secondary connected. I have this come up now and again and it's frustrating because YOU know who is prime and who's not.. We just send a simple letter to patient to contact Medicare and we give them the phone number.
Linda Walker
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One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

DMK

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Re: Medicare as Secondary
« Reply #2 on: October 10, 2013, 11:26:53 AM »
Thanks!  Palmetto processed these claims the way I've always billed them, but Noridian just kicked them out.  I'll get these re-done.

PMRNC

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Re: Medicare as Secondary
« Reply #3 on: October 10, 2013, 01:33:35 PM »
Are you saying that in past THIS patient's acct you already had setup with primary/secondary? If so maybe there was a change? I would try to call patent first.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
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dekenn

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Re: Medicare as Secondary
« Reply #4 on: October 11, 2013, 10:26:30 AM »
I don't think it's a COB issue. I think it's just a matter of how Noridian likes the info on the claim. On the top left of the claim, I always have a P for primary and S for secondary, right above the outlined box. On secondary claims, I just circle the S, and write "primary eob attached".  Sometimes, they just miss that it's secondary.

DMK

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Re: Medicare as Secondary
« Reply #5 on: October 11, 2013, 11:08:49 AM »
I have billed for these patients for several years, no new info.  I did indicate on the paper secondary claim "Primary EOB attached".  I rebilled and wrote "SECONDARY CLAIM, PRIMARY EOB ATTACHED 2 Pgs. Total" and highlighted.  We'll see.  Luckily it's very small amounts, so I can wait and see how Noridian wants these types of claims, and I only have about 5 patients where Medicare is Secondary.  Noridian is handling the primary claims really well.

PMRNC

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Re: Medicare as Secondary
« Reply #6 on: October 11, 2013, 04:11:42 PM »
It sounds like it's quite possible something changed with the secondary. Have you called to verify secondary benefits? OR could it have just been a claims processing error?
Linda Walker
Practice Managers Resource & Networking Community
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www.billerswebsite.com

DMK

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Re: Medicare as Secondary
« Reply #7 on: October 11, 2013, 05:23:54 PM »
It's looking like it's just a claims processing error.  One patient has Blue Cross as Primary, Medicare as Secondary, the other patient is Blue Shield as Primary, Medicare as Secondary.  It's just a new processor for Part B claims (Noridian took over Palmetto's work).