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Medicare Contractual obligation issue

Kayla Kenworthy 2 years ago in Billing/Electronic Modules updated by sarah 2 years ago 1

I have multiple claims that are being denied because Medicare isn't putting "Contractual Obligation" in the COB when we forward our claims to a PMAP. So, it makes it look like there is no beneficiary obligation to the PMAP. Anyone know if this can be fixed? Or what the easiest process would be?  It's impossible to talk to someone at Medicare, so I figured I would check here

I have been working with DHS on this same issue, with some of our private providers. It sounds like the best way to handle it is to get something in writing from the PMAP (or secondary provider) that states they are ok with you changing the denial reason, so that the secondary may be billed. I am going on 6 months - which doesn't help for payers with a 60-day timely filing window. If you find an answer, please let me know.