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Billing CCDTF (Rule 25) as a Secondary Payer

Jeremy Roelofs-Lynch 1 year ago in Payments/ERA Modules updated 1 year ago 4

We bill R25-CCDTF as secondary for qualifying clients. I have noticed that I am updating the COB and it leaves our clearing house correctly but in MNITS and on our ERA from MN DHS they are paying the full (original) rate...

Currently I go out and update the rates in MNITS via a replacement claim. I have a call in to them but wanted to see if anyone else has come across this???

When I have come across this it is because on the SA that they send to you there isn't a primary listed at the bottom so it pays like it is primary whether you enter the COB info in or not.

Hi Kelly - that is great info! How to I get them to note it as secondary? Is it part of the request/pw process? We have never done this and are newer to the secondary billing side of ccdtf.

thank you.

When you are verifying their coverage on MNITs is it listing a primary at the bottom right of the MNIts verification?  I have come across some that don't list a primary so they don't have it on file with the state.  If it is listed then I call the county worker who issued the SA to let them know and they should reissue a corrected SA showing there is a primary

Great - thank you for that information. I will take this to my team!