ASC Medicare claims reject PS1 When purchased service info

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Dsnooky
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Joined: Tue Mar 25, 2014 12:23 pm

ASC Medicare claims reject PS1 When purchased service info

Post by Dsnooky » Fri Apr 11, 2014 9:28 am

Good morning
I have a ASC. that is not ambulance. These are Medicare claims being rejected by Medicare, not the clearinghouse. No DME. Format must be HCFA, Medicare does not accept UB for these. I have a separate receiver for these claims with 837P. Here is the exact rejection: PAYER RESPONSE: WHEN PURCHASED SERVICE INFORMATION (2400, PS1) IS SENT, PURCHASED SERVICE PROVIDER NPI (2420B) IS REQUIRED. This is not the physicians portion. Could the smart screen for the other payers and receiver be causing this?
Thank you for your time.

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Gavin Walker
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Re: ASC Medicare claims reject PS1 When purchased service i

Post by Gavin Walker » Sun Apr 13, 2014 6:46 am

Make sure your facility is selected on the case and transaction with the NPI setup in the Facility IDs grid.
Gavin Walker
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Dsnooky
Posts: 32
Joined: Tue Mar 25, 2014 12:23 pm

Re: ASC Medicare claims reject PS1 When purchased service i

Post by Dsnooky » Mon Apr 14, 2014 9:53 am

Good morning
I checked the information you suggested and it is set up that way. Any other ideas?
Thank you and have a wonderful day

Dsnooky
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Joined: Tue Mar 25, 2014 12:23 pm

Re: ASC Medicare claims reject PS1 When purchased service i

Post by Dsnooky » Mon Apr 14, 2014 6:29 pm

Found someone else on line that was having the same issue; they are telling me that either PS1 needs to be removed or Loop 2400 added. Do you know what they would be talking about?

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Gavin Walker
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Re: ASC Medicare claims reject PS1 When purchased service i

Post by Gavin Walker » Tue Apr 15, 2014 8:01 am

Yes, they are telling you to either remove the purchased service from the claim or add the purchased service provider to the claim. Did you check the box Send Facility on the Claim in the Facility IDs grid? Also, did you check through the Facility IDs grid and delete any extra ones you don't need? You probably only need one "ALL" record for each facility.

Dsnooky
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Re: ASC Medicare claims reject PS1 When purchased service i

Post by Dsnooky » Tue Apr 15, 2014 10:49 am

Yes, send facility on claim is checked. I believe my issue is with box 24J which I cannot make blank.

Medisoft has two choices, "from Practice" or enter "national provider ID" Per rep at Medicare; for ASC box 24J is to be blank since it is not a physician claim; further, the attending provider is not listed on the claim.

I am assuming this would have to be done under "claim edit" rules against Medicare only. Given you must have a "provider" listed for each case then possiibly Provider ID-NPI for 24J leave blank; but I dont have a "leave blank" option in there. Assistance? I am out of options here.

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Gavin Walker
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Re: ASC Medicare claims reject PS1 When purchased service i

Post by Gavin Walker » Tue Apr 15, 2014 10:58 am

Well, are you using Revenue Management to submit your claims? It sounds like maybe you are using print image claims.

Dsnooky
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Re: ASC Medicare claims reject PS1 When purchased service i

Post by Dsnooky » Tue Apr 15, 2014 11:51 am

yes, I am using Revenue Management. I am not sure what you are asking about a print image. Is this something you would have support to resolve?

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Gavin Walker
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Re: ASC Medicare claims reject PS1 When purchased service i

Post by Gavin Walker » Tue Apr 15, 2014 4:15 pm

Yes, you can work directly with us if you have purchased support or Revenue Management setup. Did you do a Check for Updates in Revenue Management? Or, possibly you are using a custom iGuide that is not getting the updates.

Dsnooky
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Re: ASC Medicare claims reject PS1 When purchased service i

Post by Dsnooky » Tue Apr 15, 2014 5:35 pm

I read the file/ANSI and figured out it had nothing to do with the practice set up. I could tell it was pulling that info from the CPT Codes. When I opened the CPT Codes that were in the claim and there was a check mark on "purchased service" which is weird because it was not on all of the Codes but random. Since I set up the CPT Codes myself and never checked that box it is a mystery as to why some were like that. Not sure but since we did the recent Medisoft fix I have been finding weird things like this in the program. Once I "unchecked" that in the CPT Codes the PS1 was no longer in the ANSI file. finally mission accomplished! :D

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