How to submit Medicaid/Medicare secondary claims electronically using eClinicalWorks

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How to submit Medicaid/Medicare secondary claims
electronically using eClinicalWorks!
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(No Transcript)
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It has never been a cakewalk working
with an EHR. You know how tough it can be, if you
dont have an eClinicalWorks expert to help you
with billing needs. What do you do when you are
not aware of a certain feature or a procedure?
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We reached out to some organizations to know how
what they did to find a solution to their problem.

• Here are the top answers we would like to list
  down
• Raised the ticket with eClinicalWorks EHR but yet
  to receive a response
• Called the eClinicalWorks EHR support and was put
  on hold for thirty minutes.
• Thought of navigating to the eClinicalWorks EMRs
  guide but either didnt have time OR didnt know
  the correct path.
• Tried to use search engines but couldnt find the
  correct link.
• Called the local eClinicalWorks experts but asked
  to pay to get a solution.

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We have received inquiries on how to bill
medicaid/medicare secondary claims using
eClinicalworks EHR?

• There have been many cases where organizations
  have reported that they suffer clearing house
  rejections due to secondary claims.
• What do you need to know on submitting secondary
  claims?
• Do you change your clearing house if you face
  multiple rejections?
• What if, you want to know a list of services
  provided that have a payer as secondary?
• How do you find it without using a reporting
  tool?

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• You got frustrated with your clearing house and
  decided to send the paper claims and your
  secondary claim was denied. There could be other
  reasons for claim denials from the payer but, you
  might have missed to send a COB (Co-ordination of
  benefits) OR for the other reasons.

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• Your secondary claims were rejected and a kind of
  an error message from the clearing house which
  states the secondary identifier qualifier must be
  a valid one.  You called your clearing house, EMR
  and payer but didnt get to hear anything.

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• Suppose Medicare/Medicaid is a secondary
  insurance and you used a wrong code. Clearing
  house denies your claim. It is certainly a 5010
  issue. But insurance eligibility verification is
  equally important.

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When do you know Medicare is secondary?

• These Type codes will help you know if your
  patient has a Medicare Secondary
• Type 12 An aged employee or spouse whos
  employer has a group health plan of greater than
  twenty employees.
• Type 13 A patient has coverage under an End
  State Renal Disease coordination period for the
  first thirty months.
• Type 14 or 47 Patient has a no fault plan,
  includes liability or auto claims

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• Type 15 Patient has a workers compensation
  claim
• Type 42 One who is under a VA (veteran
  administration) plan but has been seen in VA
  facility or a VA doctor
• Type 43 Patient is disabled and the employer
  group plan has more than 100 employees

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Before you proceed with billing secondary claims,

• Make sure have the ANSI code for each patient(
  Twelve codes to choose from and dont expect the
  patients to know that)
• Dont forget to check if the CAS adjustment
  code loaded into each claim line and each of the
  claim line is completely posted.
• If you wish to differentiate between the primary
  and secondary claims, you can sign up with an MSP
  account

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And most important information which is
usually missed out

• Check the EOB date and the check date in tab
  where you need to feed the check amount.
• Dont miss to check if the Group number is loaded
  in the primary payer.

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• What if I have an eCW expert to walk you through
  six simple steps to submit secondary claims using
  eClinicalWorks EHR?
• Lets learn the step by step procedure for
  billing secondary claims through eClinicalWorks
  in our next article.

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Need a helping hand? Call us _at_ 1-609-807-8008 OR
Mail us support_at_thepracticebridge.com