loop 2320 sbr segment 05 element

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NY BILLER
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loop 2320 sbr segment 05 element

Post by NY BILLER » Mon Apr 29, 2013 5:09 pm

need to generate insurance type code 16 for medicaid 2ndry claims in loop 2320 sbr segment 05 element after primary (Medicare advantage plans as united, blue cross ....) pays the claim. unable to do it ..... please help, thanks

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Gavin Walker
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Re: loop 2320 sbr segment 05 element

Post by Gavin Walker » Mon Apr 29, 2013 7:52 pm

On the Case -> Policy 2 tab the selected insurance must be Type Medicare. Then the Medicare Secondary Reason is editable. Select Public Health Service ... (16).

The assumption is you are sending ANSI 5010 claims with Revenue Management.
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NY BILLER
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Re: loop 2320 sbr segment 05 element

Post by NY BILLER » Tue Apr 30, 2013 6:24 am

2ndry is Medicaid thr4 type is Medicaid, but primary ins info should cross over with code 16, according to mapping-type for primary should be (HMO) Medicare Risk, but revenue managment does not genarate 16, it becomes default code CI

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Gavin Walker
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Re: loop 2320 sbr segment 05 element

Post by Gavin Walker » Tue Apr 30, 2013 8:06 am

It sounds like you are sending ANSI 4010 claims. You need to switch to an ANSI 5010 IGuide.

NY BILLER
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Re: loop 2320 sbr segment 05 element

Post by NY BILLER » Tue Apr 30, 2013 9:04 am

no i am sending 5010 format in revenue,Medisoft ver 17.3.3.47

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Gavin Walker
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Re: loop 2320 sbr segment 05 element

Post by Gavin Walker » Tue Apr 30, 2013 10:41 am

Try checking for updates and switch to the standard ANSI 5010 IGuide.

NY BILLER
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Re: loop 2320 sbr segment 05 element

Post by NY BILLER » Tue Apr 30, 2013 11:13 am

I HAVE MOST CURENT REVENUE MNGMT, AND I AM IN standard ANSI 5010 IGuide

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Gavin Walker
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Re: loop 2320 sbr segment 05 element

Post by Gavin Walker » Tue Apr 30, 2013 1:58 pm

You'll have to work directly with a reseller who can setup Revenue Management. The default for SBR 05 should be 47 when there is secondary Medicare and SBR 09 should default to CI for commercial insurance.

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