arunyan1
New
Hello, I'm having issues with denials from Medicaid secondary claims.
The patient has Humana PPO as primary insurance. Medicaid is denying my claims because my primary Insurance filing indicator, according to Medicaid needs to be medicare part B.
In my practice management system I have Medicare Part B selected. When my claims are processed through my clearinghouse they are changing the filing indicator from MB to Commercial Insurance.
My clearinghouse representative said that they only process commercial insurance or 16 HMO medicare risk for Humana/medicare. The representative instructed me to select 16 HMO Medicare Risk.
I'm not sure what to do at this point. I feel like if I select 16 HMO medicare risk may cause other issues, because this member has an PPO plan.
Thank you
The patient has Humana PPO as primary insurance. Medicaid is denying my claims because my primary Insurance filing indicator, according to Medicaid needs to be medicare part B.
In my practice management system I have Medicare Part B selected. When my claims are processed through my clearinghouse they are changing the filing indicator from MB to Commercial Insurance.
My clearinghouse representative said that they only process commercial insurance or 16 HMO medicare risk for Humana/medicare. The representative instructed me to select 16 HMO Medicare Risk.
I'm not sure what to do at this point. I feel like if I select 16 HMO medicare risk may cause other issues, because this member has an PPO plan.
Thank you