I'm hoping someone out in the community has an answer to this question.
If an ARMHS client has Medicare as their primary insurance payer and PMAP/MA as their secondary payer and is seeing a NON-Medicare provider, how to we bypass Medicare and bill the PMAP plan or the MA plan as the primary insurance plan? Do we need a modifier to do so?If a modifier is required, what is the modifier code used bypassing Medicare, billing PMAP/MA as the primary payer.
I'm advised we should bill Medicare first and get the denial then send the claim to the secondary plan, PMAP/MA.
Does anyone have experience with this? I'd love to hear from someone. Thank you for your time.
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