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Takebacks

emilee miller 6 months ago in Payments/ERA Modules updated by Chris Werner (Customer Success Manager) 6 months ago 6

Insurance termed so I posted the takeback to the clients account. What exactly are the next steps that I need to do so I can rebill this to secondary ins for the full amount of the claim??? 

I have one here that is BCBS doing the take back and 2ndry was Blue Plus, which now would be primary...

You can send them as replacement claims. Make sure the COB tab has all the info and the correct denial code (code 27 I believe). They will do a take back of any payments made and then pay at the correct amount.

Do I have to go in and manually enter anything regarding the CARC codes for instance CO-45  when originally sent was for $87.42 and now that there is a takeback do I have to enter it in the COB tab in the Time module as a negative amount?? 

how can i send out a replacement claim if the claim is a zero balance due to the Payment/Adjustment etc...

You will use the ref # from each claim for each DOS and put that in the "extra info tab". The denial should carry over form the ERA they did the tb on

Here is a Knowledge Hub article that should help you when billing the secondary payer.  

Hope this helps you!

https://support.procentive.com/ERAs/Articles/Process_an_ERA_to_a_Secondary_Payer