Secondary Claims after Medicare - sending electronically

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saxman2u
Posts: 33
Joined: Tue Feb 21, 2012 10:26 am

Secondary Claims after Medicare - sending electronically

Post by saxman2u » Thu Apr 20, 2017 11:50 am

We have a small number of secondary insurance companies' claims that Medicare does not electronically forward to them. I guess they are small outfits that do not have the capability for some reason. Just for clarification, the Medicare EOB for these patients show that the claim is not forwarded to any secondary insurance.

Some of these insurance companies are also unable to receive an electronic claim from our office that we send through Mega Easy. We are forced to drop to paper and mail to secondary along with a paper Medicare EOB. What a hassle.

Recently, one of our secondaries informed us that if we complete the "EDI Extra 1 / Medigap" field under the EDI/Eligibility tab with a particular 5 digit number (in this case, it was 55000), this will inform Medicare of a secondary insurance and they will automatically forward it to the secondary. Sure enough, on a most recent Medicare EOB, it showed that Medicare was forwarding the claim automatically to the secondary insurance.

For the other insurance companies that I have this issue with, do they also have this capability? Do I have to call each one, or does the 55000 input solve this problem? Was wondering what other people are doing? I get tired of mailing out paper claims, especially when we are doing repeat billings.

Thanks,
-S

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Gavin Walker
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Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
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Re: Secondary Claims after Medicare - sending electronically

Post by Gavin Walker » Thu Apr 20, 2017 1:37 pm

On your Medicare intermediary's website, see if they have a list of Medigap numbers for various insurance companies. This is the number you would put in that field. You'll need to check the list every now and then for updates.
Gavin Walker
Walker Tek Solutions, LLC
866-890-6777
417-890-6777

saxman2u
Posts: 33
Joined: Tue Feb 21, 2012 10:26 am

Re: Secondary Claims after Medicare - sending electronically

Post by saxman2u » Fri Apr 21, 2017 10:56 am

Thanks! This is great information!

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