How To Fix Medicare Secondary Claims Rejections 

Claims got ya’ feelin’ Coo-Coo? We can help!      Image via Google.

If you have been experiencing any rejections on claims sent, specific to Medicare showing as your secondary source of insurance for a patient, we are confident this blog post can help!

First and foremost, Medicare is typically for the elderly, so most patients will have this insurance as their primary insurance carrier. It is rare for claims to show Medicare Insurance as secondary, mostly being flagged by insurances to say, “hey, why is this showing as secondary and not primary?!”

We have a solution for you: When you are working within Medisoft, to correct these claims that may be rejected, there is a specific drop down box for this instance when maybe the patient is still of working age or disabled and does not have Medicare as their primary insurance carrier. If you are sending Medicare secondary claims, there is additional information that must be filled out, and we will show you how!

Getting started:

Common errors will show something like, “Medicare needs the identity of the primary payor” or “CO-16 error” on your Explanation of Benefits (EOB).

You need to make sure on all these electronic Medicare secondary claims that you have a Medicare Secondary Payor Type or more commonly known as MSP Type Code.

A complete list of these codes can be found here!

There are entered on the same page as the Medicare information when it’s entered as secondary in your Medisoft program.

Let’s see how it’s done:

This drop down list of these codes is found in the case and is always required if Medicare is the secondary insurance on a claim.  That is the only time these codes are needed and will appear for selection.

Now, If the drop down list is grayed out and won’t let you select from it, that means the Medicare insurance code is not setup as a Medicare insurance type.  It has to be a Medicare insurance type.

Let us know how this worked for you! Give us a call or leave a comment!

Need even more help? We are here for you!