SECONDARY TO MEDICARE

[billing1]

scenerio= medicare pays claim/ sends to secondary ins which has since been changed to another insurance/
is there a way to send electronically to new insurance so they can see medicare paid
or do i have to send a paper hicfa (secondary) and fax medicare eob ?? i hope i explained this ok

[Gavin Walker]

Yes, there is, just edit the claim and change the insurance. Don't forget to make the change on the case as well.

[billing1]

sorry gavin can you walk me thru it

[Gavin Walker]

Just double-click the claim to edit it in Claim Management window.

[billing1]

i know how to change on the claim managment but what do i change and how on the case? how do i make sure only the secondary goes ? what does that crossover claim under assignment of benefits/accept assignment mean

[Gavin Walker]

On the case go to the Policy 2 tab and change the Insurance 2 field. This will cause future transactions to go to the new secondary insurance.

Check Crossover Claim if you know the primary insurance (or your clearinghouse) will automatically forward the claim to secondary insurance for you. If this will not happen, then leave Crossover Claim unchecked. If you needed to check/uncheck Crossover Claim, then click Update All in Transaction Entry after you have made the change.

[billing1]

i dont think we are on the same page
when i have medicare as primary and uhc as secondary and medicare does not medigap for whatever reason
how do i do this for sending uhc claim (hopefully sending the posting from medicare so uhc can see it paid)

[Gavin Walker]

If I understand what you are saying, you uncheck Crossover Claim on Case -> Policy 2 tab and click Update All in Transaction Entry.

[billing1]

it was never checked we are not on the same page
if medicare doesnt medigap a claim how do i send the secondary letting them know medicare has paid

[Gavin Walker]

You can use Revenue Management. There is an option to Select Secondary Claims. Just send them like you do your primary claims.

[billing1]

so when i send it that way dont they need to see that medicare pd ??
do i need to show adjustments some how?
or will they see it on there end

[Gavin Walker]

All that information is automatically included on the secondary claim assuming you entered the payments/adjustments into Medisoft.

[billing1]

OH THATS GREAT THANKS SO MUCH