Creating $0 claims

Barbiaux · Post by **Barbiaux** » Wed Mar 29, 2017 12:30 pm

One of our providers needs to report all diagnosis codes to 1 insurance company. Medisoft can handle more than 4 but the insurance company can only receive 4 on 1 claim. They directed us to send 99213 with first 4 at normal charge and then a 2nd and 3rd 99213 with the other DX but send it as a $0.00 charge amount. When we do it this way the $0 lines are not getting created so not getting sent. For awhile we were making the 2nd and 3rd line $0.01 but the insurance keeps paying those and denying the primary line. Even with a 25 mod on the primary they were still paying wrong and it has just been a pain.

So all that to get to my question, is there a way to create the $0 claims from claim management when creating the end of day batch?

Post by **Gavin Walker** » Wed Mar 29, 2017 1:34 pm

I believe what you will need to do is enter the same list of all diagnosis codes on all procedures on the claim, but only check up to 4 diagnosis pointers on each procedure code. That will cause all the procedures go out on the same claim.

Barbiaux · Post by **Barbiaux** » Thu Mar 30, 2017 5:16 am

thank you for the response. The payer is Highmark BC/BS. We send the claims directly to them and not through a clearinghouse. I tried doing that last month and when there are more than 4 on a line, even when only 4 are checked they still reject. Any other ideas? Last resort we can go back to the $.01 claims and just deal with the ones that are problems.

Post by **Gavin Walker** » Thu Mar 30, 2017 10:17 am

The ANSI standard allows up to 12 diagnosis codes on a claim. What message are you getting on the rejection?

In Claims Management when you click Create Claims, the Create Claims window appears. In the Enter Amount field, enter -1.