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MA denials for missing other plan information
We are consistently getting denials from MA when billed as secondary saying "missing other plan informaition" - specifically when primary is Medicare or a Medicare advantage plan. The COB is correct and have tried adding the svd segment manually, nothing works. Any ideas?
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Are you talking about MN MA? I haven't seen it yet with MN MA though for our claims, but maybe we just haven't had a client with that combo just yet. But we had this issue with our ND MA claims and it ended up that ND MA changed to where if the client had Medicare or a Medicare Advantage plan as primary, when billing to ND MA as secondary they wanted the claim to come through with an MB for the Claim Filing Indicator of which Procentive had to create for us. So that might be the same thing here with MN MA possibly.
Yes, us too with MN MA and Medicare or Medicare Advantage plan - have no idea why and our COB is correct as well. Probably need to open a case with Procentive to see if we need a different modifier.
So many Secondary claim glitches this year. I am also getting these denials. side note but When working with Procentive recently on another related type glitch, I was told that you NO LONGER have to manually poplulate the svd field. That glitch is fixed.
Update- I am still getting denials from MA for a perfectly sent 2ndary claim. If you look at the claim data of the MA claim, says: Payer Order- P.
This is a glitch. It should say S.
That is why the primary COB isn't traveling. This needs to be fixed. Have a ticket in to Procentive.
Another thing I learned is that the secondary insurance must now have the True secondary field set to Yes.
And send other insurance info set to yes.
I have never had to do this in the past to bill secondary but now you do. I think that solved my MA secondary issue.
Wow, having to change those settings for every secondary MA insurance client, is going to be so annoying and time consuming. Like what the heck happened that we now have to do that when we've never had to do that before.
I know. And I'm having trouble on repl claims I'm doing after I changed the settings. It's like the claim is locked in as a primary claim and won't go out as a secondary. I can't send a new claim b/c it gets denied as a dupe. (For non-MA payer).