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loop 2320 sbr segment 05 element

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

Re: loop 2320 sbr segment 05 element

Posted: Mon Apr 29, 2013 7:52 pm
by Gavin Walker
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.

Re: loop 2320 sbr segment 05 element

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

Re: loop 2320 sbr segment 05 element

Posted: Tue Apr 30, 2013 8:06 am
by Gavin Walker
It sounds like you are sending ANSI 4010 claims. You need to switch to an ANSI 5010 IGuide.

Re: loop 2320 sbr segment 05 element

Posted: Tue Apr 30, 2013 9:04 am
by NY BILLER
no i am sending 5010 format in revenue,Medisoft ver 17.3.3.47

Re: loop 2320 sbr segment 05 element

Posted: Tue Apr 30, 2013 10:41 am
by Gavin Walker
Try checking for updates and switch to the standard ANSI 5010 IGuide.

Re: loop 2320 sbr segment 05 element

Posted: Tue Apr 30, 2013 11:13 am
by NY BILLER
I HAVE MOST CURENT REVENUE MNGMT, AND I AM IN standard ANSI 5010 IGuide

Re: loop 2320 sbr segment 05 element

Posted: Tue Apr 30, 2013 1:58 pm
by Gavin Walker
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.