Ordering Provider Information

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Posts: 5
Joined: Wed Jan 14, 2009 7:39 pm

Ordering Provider Information

Post by jhorse217 » Wed Jan 14, 2009 7:48 pm

We are submitting claims via Medavant clearinghouse and are receiving an error concerning Ordering Provider information missing. In ANSI crosswalk, it shows the loop to be 2420E. Medavant states that they do not recognize it. Has anyone had success with submitting Order Provider information. If so what loop did you use? We tried using loop 2310A, with no success.

The bigger requirement is to be able to submit to Noridian Medicare. Other connecting to the clearinghouse, what other methods are you using to submit claims to them, but still using Medisoft.

We are on Medisoft v10.


Midwest Medical

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

Post by Gavin Walker » Sat Jan 17, 2009 10:52 pm

Hi Jeanne, first if you are successfully submittng any Medicare claims through MedAdvant, then you should count yourself fortunate. Medisoft was not changed to support the NPI changes required by Medicare until v11 sp4. So if Medicare is working for you, then MedAdvant must be plugging in the NPI number for you.

Second, although a couple of Medisoft Direct Modules can send loop 2420E, they are not designed to be used with Noridian Medicare. What procedures are you trying to bill that require the ordering physician? Can you post the exact error message that you get from MedAdvant? That might shed some light on this error.

If you must send loop 2420E to Medicare, then I don't see you getting around this problem without upgrading. If you stick with MedAdvant clearinghouse, Medisoft will need to modify the Phoenix module to support this. Since Medisoft is currently trying to migrate everyone to the RelayHealth clearinghouse, I don't see this happening. The next option will be to push Medisoft into modifying the Noridian Medcare Part B (NDMB) module to support this loop. I would wait until Medisoft comes out with the fix first, before upgrading your Medisoft. SendClaim is also available, but that option is even more expensive.

Your other option will be to switch to a clearinghouse that has the ability to map the Ordering Physician for you. I would make sure the clearinghouse has this capability before making the switch.
Gavin Walker
Walker Tek Solutions, LLC

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