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Forwarding a Secondary Claim to Maryland Medicaid

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Carefirst insurance denied a patient claim by applying the payment amount to the patient's deductible.

However, the patient had Maryland Medicaid as a secondary insurance. When I forwarded the denied claim to Maryland Medicaid via CMS 1500 paper claim, Maryland Medicaid sent the claim back to me for the following reasons:

1.) This claim is being returned because the patient's 11 digit Medical assistance number must be in Block 9A

2.) The top center and right side of the CMS 1500 paper claim must be left blank.

If I'm supposed to write the medicaid ID # in block 9a but I'm not supposed to write anything on the right side, in what block should I write the Carefirst ID #? And in what block should I write the Carefirst insurance name itself.

I would greatly appreciate it.

The Carefirst ID number should be in block 1a of the CMS 1500 with the Maryland Medicaid number in block 9a. Maryland Medicaid doesn't want anything printed/written on the TOP center and right hand side of the CMS 1500 form (the blank space above the red line) so if  something is there it has to be removed. And remember to attach the Carefirst EOB when you resend the claim to Medicaid. Hope this helps.

No problem. Thanks

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