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PostPosted: Wed Aug 27, 2014 11:29 am 
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Joined: Tue Jan 10, 2012 2:40 pm
Posts: 7
Using Medisoft v19 SP1 - Revenue Management for claims - MD On-Line clearinghouse.
Our patient's last name is ST ROMAIN. This is exactly how it appears on the insurance card and how we have it entered in patient information. When the claim reaches the clearinghouse, the spacing is removed- STROMAIN. The insurance company rejects the claim at the clearinghouse level because it does not recognize the name. We tried submitting with extra spacing between the T and R - the spacing is always removed. We tried it with a period - ST. ROMAIN - but the claim is received as ST.ROMAIN and rejected. Paper claims do the same thing. This insurance company is super picky about spelling apparently because others with spacing removed went through fine. Any ideas?


Last edited by eyedrwool on Wed Aug 27, 2014 11:42 am, edited 1 time in total.

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PostPosted: Wed Aug 27, 2014 12:51 pm 
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Joined: Wed Apr 04, 2007 10:11 pm
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Location: Springfield, MO
Who is the insurance? And is this a Medicare Replacement Policy?

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PostPosted: Thu Aug 28, 2014 10:50 am 
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Joined: Tue Jan 10, 2012 2:40 pm
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It's Blue Cross Blue Shield of Louisiana. Regular commercial plan. We recently upgraded from V8 to V19. Claims prior to the upgrade for this patient have the space and were processed. I have other patients with similar names (ST ...) and those claims to other insurance companies are accepted without the space.

I spoke with a representative from Blue Cross. Because the claim is being rejected at the clearinghouse, they can't evaluate the situation. The rep suggested that we file a paper claim. If it gets rejected, they can take a look at it.


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PostPosted: Thu Aug 28, 2014 11:23 am 
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Joined: Wed Apr 04, 2007 10:11 pm
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Location: Springfield, MO
Currently, there is special processing to leave spaces in if the insurance type is Medicare. As a work around, you can set Blue Cross Blue Shield of Louisiana to type Medicare. Alternatively, you can work with a Medisoft re-seller who can customize a Revenue Management iGuide to make this work for Blue Cross Blue Shield of Louisiana. I will let McKesson know that Blue Cross Blue Shield of Louisiana is another insurance that needs this special handling.


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PostPosted: Fri Aug 29, 2014 8:45 am 
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Joined: Wed Apr 04, 2007 10:11 pm
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Location: Springfield, MO
I also found out on your paper claims, you can modify the report template in Design Custom Reports and Bills and change to print the field Patient Full Name LFM.


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