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MEDICAID ALLOWANCE INCLUDES FULL MEDICARE DEDUCTIBLE AND MAY INCLUDE FULL OR PARTIAL COINSURANCE

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Rejection Message

MEDICAID ALLOWANCE INCLUDES FULL MEDICARE DEDUCTIBLE AND MAY INCLUDE FULL OR PARTIAL COINSURANCE

Rejection Details

This rejection indicates that Medicaid has a different primary insurance on file for this patient.

Resolution

Resolution steps will vary depending on the cause:

  1. Have the patient contact Medicaid to update their patient file to reflect Medicaid as the primary payer.
  2. Make the necessary changes to the patient case to reflect the correct coordination of benefits.
    1. Transfer the balance of each claim to the appropriate payer.

Then, rebill and resubmit all affected claims.
Tip: Most subscription levels include access to a free eligibility check feature which can be used with many payers to verify a patient has active coverage. Utilizing this feature prior to submitting claims for a patient can help prevent this type of rejection.