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Invalid Amt/COB out of Balance

Posted: Wed Mar 15, 2017 12:31 pm
by maglab
How do I fix a claim that has Medicare as secondary and the claim has an error saying invalid amt/cob out of balance
invalid sl paid amount

Re: Invalid Amt/COB out of Balance

Posted: Wed Mar 15, 2017 2:33 pm
by Gavin Walker
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.

Re: Invalid Amt/COB out of Balance

Posted: Wed Mar 15, 2017 2:58 pm
by maglab
The claim that is having this problem was still the original claim. We posted a zero payment on all line items. The provider write off is correct. Still don't know why the amount would be wrong

Re: Invalid Amt/COB out of Balance

Posted: Tue Apr 18, 2017 8:41 am
by Gavin Walker
Did you mark all the zero payments complete?