Make sure the claim you are sending Medicare is the same as what you sent to the primary payer. So if you had 6 procedures on the claim to the primary payer then the same 6 procedures must be sent to Medicare.
Here are a couple of ways I can think of that will cause this to get out of balance:
1. You delete procedures that were previously send to the primary payer.
2. You used the split claim feature to remove procedures that were originally sent to the primary payer onto a new claim.
So, you must enter and apply payments on all line items on the claim from the primary payer even if they are a zero pay or a denial. If you need to challenge a payment for a line item from the primary payer, then you have to challenge the entire claim and you can't split the claim and send part of it on to the next payer.
I hope that helps.
Walker Tek Solutions, LLC