1. Procentive User Community
  2. Payments/ERA Modules
  3. Ideas
0

Takebacks

emilee miller 5 years ago in Payments/ERA Modules • updated by Chris Werner 5 years 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??? 

TVano 5 years ago

Is the secondary DHS?

emilee miller 5 years ago

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

TVano 5 years ago

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.

emilee miller 5 years ago

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...

TVano 5 years ago

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

Chris Werner 5 years ago

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

Customer support service by UserEcho