Other Payer Insurance Type is required when Payer is Medicare - Not Primary

Rejection Message

Other Payer Insurance Type is required when Payer is Medicare (Not Primary)

Rejection Details

This rejection has two possible causes:

1. Medicare is listed as secondary insurance on the patient's case and the Insurance Type field on the policy page has been left blank.
2. Both insurances billed on the claim was Medicare. When Medicare is listed as one of the payers on a claim, the other payer(s) listed cannot also have an Insurance Program of MB- Medicare Part B.

Resolution

Resolution steps will vary depending on the cause.

If Medicare is the secondary, follow the instructions below to enter the insurance type code:

1. Click Encounters > Track Claim Status. The Find Claim window opens.
2. Look for and double-click on the encounter that needs correcting. The Edit Claim window opens.
3. Double-click on the Case. The Edit Case window opens.
4. Double-click on the Medicare policy listed as secondary. The Insurance Policy window opens.
5. Select the correct Insurance Type from the drop-down menu.
6. Click Save all the way out (multiple saves may be required).

Then, rebill and resubmit all affected claims.

If the insurance program was incorrectly setup, follow the instructions below to change the insurance program code:

1. Click Encounters > Track Claim Status. The Find Claim window opens.
2. Look for and double-click on the encounter that needs correcting. The Edit Claim window opens.
3. Double-click on the Case. The Edit Case window opens.
4. Double-click on the appropriate Insurance Policy. The Insurance Policy window opens.
5. Double-click on the Insurance Name. The Edit Insurance Plan window opens.
6. Double-click on the Insurance Company 
    name. The Edit Insurance Company window opens.
7. Click the Insurance Program drop-down to select the  correct insurance program code.
8. Click Save all the way out (multiple saves may be required).

Then, rebill and resubmit all affected claims.