Billing Masshealth Secondary Claims Electronically
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Billing Masshealth Secondary Claims Electronically
All I know is that I billed secondary claims to Masshealth but they denied saying they were missing Coordination of Benefits info/the carrier code.
Does anyone have experience billing Masshealth secondary or know what I'm talking about? Any guidance is appreciated!
- Gavin Walker
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Re: Billing Masshealth Secondary Claims Electronically
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386
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Re: Billing Masshealth Secondary Claims Electronically
For example, I have a patient with Cigna primary and Masshealth secondary. Before I can send the claim to Masshealth I need to attach Cigna's carrier code to the claim. According to Masshealth's billing guide this 7 digit code should be in Loop 2330B segment NM1 09. I don't know where to enter the code in Medisoft to accomplish this.
- Gavin Walker
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Re: Billing Masshealth Secondary Claims Electronically
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Re: Billing Masshealth Secondary Claims Electronically
The problem lies in a piece of information that must be present in the electronic claim I submit to them. Masshealth has their own list of "carrier codes" which can be seen here: http://www.mass.gov/eohhs/docs/massheal ... -c-all.pdf
Masshealth needs this carrier code listed in Loop 2330B segment NM1 09, as stated by them in their billing guide (and a representative when I called). I looked this segment up in the Medisoft help guide and it looks like I should enter this carrier code into the "EDI Extra 1/Medigap" line, but I'm not sure. It looks like that might interfere with the Claims Payer ID.
...when I used to send secondary claims to Masshealth on paper, I would simply send an EOB with a claim form and I could write the carrier code right on the claim form, it would go in box 11c. They wouldn't pay secondary claims without it. Same situation here, except I can no longer send a paper claim so I must figure out how to attach this carrier code.
- Gavin Walker
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- Joined: Wed Apr 04, 2007 10:11 pm
- Location: Springfield, MO
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Re: Billing Masshealth Secondary Claims Electronically
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- Posts: 11
- Joined: Thu Nov 17, 2011 11:56 am