SSN needed for Subscriber for work comp claims

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ProCareSabrina
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Joined: Thu Dec 03, 2015 7:36 pm

SSN needed for Subscriber for work comp claims

Post by ProCareSabrina » Fri Oct 14, 2016 3:44 pm

Hello!

I have switched to Trizetto as my clearinghouse. I am getting the following rejection message for my work comp claims submitted: "SS number needed for the Subscriber."

Per the set up MedTech gave me for my Medisoft Ver 19 for my previous clearinghouse, i was told for work comp claims, the Subscriber/INsured/Policy holder had to be the Employer, Relationship status had to be Employee. Does that mean that we need to make up an SSN for the Employer as entered?

Trizetto tech also told me: For work comp it will go in the: 2010CA LOOP

Can you pls confirm where the SSN belongs, and if it IS for the Employer, can we make one up as we did for a dob, or do we have to get their TIN?

Please advise. Thank you!

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Gavin Walker
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Re: SSN needed for Subscriber for work comp claims

Post by Gavin Walker » Sat Oct 15, 2016 1:19 pm

The patient would be the policy holder / employee right? So the SSN goes on the patient. The employer would be setup as an insurance company and set the type to workers' comp.
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ProCareSabrina
Posts: 55
Joined: Thu Dec 03, 2015 7:36 pm

Re: SSN needed for Subscriber for work comp claims

Post by ProCareSabrina » Sat Oct 15, 2016 1:25 pm

That would be different than how i was told to set it up before.

Right now, Insurance is the work comp carrier (ie Sedgwick, Liberty Mutual, etc)
The Policy Holder is the Employer (ie Dell, Exxon, etc)
Relationship to INsured is then "Employee"

An SSn is already assigned to the patient info under Chart set up.

So where does the SSN go for subscriber? I assume it's the Policy holder.

Or are you saying we need to change the policy holder back to the patient? I'm still not sure how I could set the employer up as an insurance co and where, as the ins co assigned is where the bills have to go.

Hope I'm using the right lingo...

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Gavin Walker
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Re: SSN needed for Subscriber for work comp claims

Post by Gavin Walker » Sat Oct 15, 2016 2:51 pm

Try entering the Tax ID in the SSN field. We don't have an option for tax id on a guarantor in Medisoft.

ProCareSabrina
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Re: SSN needed for Subscriber for work comp claims

Post by ProCareSabrina » Mon Oct 17, 2016 11:59 am

Gavin Walker wrote:Try entering the Tax ID in the SSN field. We don't have an option for tax id on a guarantor in Medisoft.
I was unable to find the TIN for the employer, so I made up a 9 digit entry for the SSN field for Policy Holder 1.

Got the same denial: "SSN needed for Subscriber"

I even tried changing back the policy Holder to the Patient and Relationship to Self. I know the pt's SSN is in there.

Got the same denial: "SSN needed for Subscriber"
????

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Gavin Walker
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Re: SSN needed for Subscriber for work comp claims

Post by Gavin Walker » Mon Oct 17, 2016 7:35 pm

I believe we have a custom IGuide we developed for this. I'll hop on your system to see if you have it. If not, I'll give you ours.

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