Sending Corrected Claims-Payer Claim Control Number needed

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saxman2u
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Sending Corrected Claims-Payer Claim Control Number needed

Post by saxman2u » Tue Feb 28, 2012 5:20 pm

We are trying to send a corrected claim to BCBS TX. Like the other insurance companies, we send a corrected claim bu putting a "7" in the "frequency type" box of the claim. This works for the commercial insurance payers. However, when we do this for BCBS, we receive an EDI reject from Availity stating:

Payer Claim Control Number is required

Where does this information go and what are they asking for? The original insurance claim number?

Thanks,
Scott

saxman2u
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by saxman2u » Tue Feb 28, 2012 5:28 pm

this is the actual message:


RMSG: HIPAA R0x3938bda
Payer Claim Control Number is required.
Loop: 2300 Segment: REF Element:

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Gavin Walker
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by Gavin Walker » Wed Feb 29, 2012 9:46 am

This field comes from Case -> Medicaid and Tricare tab -> Original Reference.

On the EOB you got back there should have been a claim reference number that was generated by the insurance company. That is what they want on the resubmission.
Gavin Walker
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fax: 417-763-6386

saxman2u
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by saxman2u » Wed Feb 29, 2012 10:06 am

SO, just for clarification, even if it is a commercial payer, go ahead and put the original claim number in that field on the medicare/tricare tab?

After my original post, my medisoft support person told me that this information should go under case>policy one>Document Control number? Not try to disagree, just trying to figure out what all the fields mean.

Thanks!

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Gavin Walker
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by Gavin Walker » Wed Feb 29, 2012 10:26 am

Yes, go ahead and enter it regardless of the insurance. If you are using Revenue Management, and you are using the standard 5010 Professional IGuide that came from McKesson, then Medicaid Original Reference Number is the field that is being used to populate the Claim Control Number in the ANSI file. Please report back your solution when you find it.

saxman2u
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by saxman2u » Wed Feb 29, 2012 10:37 am

We are just using Medisoft Network Professional with OH PRo. V 17.2.2.173.

Just for clarification, you are recommending the Case -> Medicaid and Tricare tab -> Original Reference field, and not the document control number for my corrected claim issue?

Thanks

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Gavin Walker
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by Gavin Walker » Wed Feb 29, 2012 10:49 am

So are you doing print image instead of using Revenue Management?

saxman2u
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by saxman2u » Wed Feb 29, 2012 10:56 am

yes, claim management >print/send button.

Using MegaEasy EDI Module that submits electronic claims thru Availity.

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Gavin Walker
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by Gavin Walker » Wed Feb 29, 2012 11:33 am

Mega-easy uses it's own processing logic, so it very well could pull information from a different fields than Revenue Management. I don't know much about Mega-easy, so please post back when you find a solution. You might help the next Mega-easy user that comes along.

sathish_kaizen
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by sathish_kaizen » Thu Jul 12, 2012 10:11 am

[Medisoft V17] If you Using MegaEasy EDI Module that submits electronic claims thru Availity you
should go under Case->Policy 1->Claim Number and put the payer claim control number.

saxman2u
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by saxman2u » Thu Jul 12, 2012 4:17 pm

yes, thanks for the information!

sathish_kaizen
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Re: Sending Corrected Claims-Payer Claim Control Number need

Post by sathish_kaizen » Tue Mar 26, 2013 11:21 pm

I want to send multiple corrected claim from the same case, in this case how can we add previous Claim number for each corrected claim?

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