Relay Health Medicare Secondary

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PPS3510
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Joined: Fri Sep 23, 2016 10:01 am

Relay Health Medicare Secondary

Post by PPS3510 » Wed Feb 22, 2017 10:54 am

I need HELP!!! I have a continuous problem with filing Medicare as a secondary (Aetna-primary; Medicare-secondary). I can file it and send it but Medicare claims they NEVER receive the claim and/or never get the primary insurance processing information. I have contacted Sunrize (who we use for MediSoft support) and feel like I'm getting no where. I know I can not submit paper claims to Medicare with the primary EOB...so does anyone have any guidance on this topic?

TIA

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Gavin Walker
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Re: Relay Health Medicare Secondary

Post by Gavin Walker » Wed Feb 22, 2017 12:19 pm

Are you using Revenue Management to submit you claims in ANSI 5010 format?
Gavin Walker
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PPS3510
Posts: 10
Joined: Fri Sep 23, 2016 10:01 am

Re: Relay Health Medicare Secondary

Post by PPS3510 » Wed Feb 22, 2017 12:58 pm

yes we are

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Gavin Walker
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Re: Relay Health Medicare Secondary

Post by Gavin Walker » Wed Feb 22, 2017 2:44 pm

On the Process Claims window in Revenue Management go to Select -> Pri. & Sec. -> Ready to Send to select both primary and secondary claims to submit on your next batch.

PPS3510
Posts: 10
Joined: Fri Sep 23, 2016 10:01 am

Re: Relay Health Medicare Secondary

Post by PPS3510 » Tue Jan 22, 2019 11:36 am

I am having the same issue. Medicare continues to not get the information for processing from primary EOB. Is there a place I need to add a claim number or something? We cant issue a paper claim w/primary EOB and unable to attach eobs via RM.

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Gavin Walker
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Re: Relay Health Medicare Secondary

Post by Gavin Walker » Wed Jan 23, 2019 4:12 pm

On the Case -> Medicaid and Tricare tab there is an Original Reference field. Enter the clam number there. In some cases they also need a Re submission Number. Enter that in the field just below.

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