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Medicare (primary insurance) crosses over claims to Medicaid (secondary). Medicaid doesn't receive these claims.
What could be the reason? Medicare doesn't receive any rejection from Medicaid. Medicaid saying no claims are received from Medicare. Contacted both insurances multiple times. NO solutions found. Any idea?
Thank you

How do you submit the claims to Medicare?

Electronically.

Are you sending claims direct to Medicare or are you using a clearinghouse? Are you using Revenue Management? Are these Print Image claims, ANSI 4010, or ANSI 5010 claims?

Using Revenue Management to send claims through Clearing House to Medicare. Apparently can print the claims, hadn't done that yet.

You can simply send your secondary claims through the same clearinghouse using Revenue Management. On the list of things to do is to enhance the way crossover claims work in Revenue Management.

Here are the triggers that are supposed to cause Revenue Management to send secondary payer info on the primary claim for crossovers:

1. Check Crossover Claim on the Policy 2 tab of the case.
2. On the secondary Insurance Carrier EDI/Eligibility tab, enter the Medigap number in the EDI Extra 1/Medigap field.

Do you have EDI Extra 1/Medigap for Medicaid by any chance, my Clearing House doesn't have that information.
Thank you

You will have to go to your Medicare intermediary to get the list of Medigap payer ids. Normally you can find this on their website.

Thank you very much. Will try

Gavin Walker wrote:How do you submit the claims to Medicare?

medicare farwoded to bs-ca directly

abdulrahman wrote:

Gavin Walker wrote:How do you submit the claims to Medicare?

medicare farwoded to bs-ca directly

if claim not on file what we can do?

I assume you are saying Medicare forwarded the claim to a secondary payer but the secondary payer was not setup in Medisoft. What you can do is go ahead and add the secondary payer information to the case and make sure you click Crossover Claim on the Policy 2 tab. Then in Transaction Entry click Update All.

So, I wasn't able to find Medigap for Medicaid. I contacted both Medicare and Clearing House.

Who is your Medicare intermediary?

NGS