Qualifier for Amerihealth

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Dgray
Posts: 6
Joined: Sun May 20, 2007 10:19 am
Location: Berlin, NJ

Qualifier for Amerihealth

Post by Dgray » Tue Sep 25, 2007 11:47 am

I have been receiving rejected claims from Amerihealth, Keystone and IBC. They said that the Qualifier was incorrect and that this is a problem in New Jersey. My question is where does it go in the system so that it will print on the claim. I have Medisoft version 8.0 sp2.
Debra Gray
3D Medical Billing Inc.

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Gavin Walker
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Location: Springfield, MO
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Post by Gavin Walker » Wed Sep 26, 2007 9:48 am

Hi Debra! The qualifier on the CMS-1500 report for Medisoft version 8 that we sent you is calculated by the insurance type. Therefore it is important to pick the correct insurance type on your insurance carrier. Here is how that is calculated:
Medicare = 1C
Medicaid = 1D
Champus = 1H
Blue Cross/Shield = 1A
Other = G2
HMO = BQ
PPO = B3
Tricare = 1H
Gavin Walker
Walker Tek Solutions, LLC
417-890-6777 x0
fax: 417-763-6386

Dgray
Posts: 6
Joined: Sun May 20, 2007 10:19 am
Location: Berlin, NJ

Post by Dgray » Thu Sep 27, 2007 11:49 am

After calling Amerihealth they said that it should be 1B. Where is this found. I understand what you are saying as far as the other code ie Medicare 1C etc, just not sure where this is indicated in the software. What tab should I be looking at?
Debra Gray
3D Medical Billing Inc.

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Gavin Walker
Posts: 4625
Joined: Wed Apr 04, 2007 10:11 pm
Location: Springfield, MO
Contact:

Post by Gavin Walker » Fri Oct 05, 2007 1:45 pm

Debra, give our office a call when you are ready to work on this. We will need to modify your reports to include a 1B when Blue Cross/Blue Sheild is selected

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