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Kareo Help Center

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

Rejection Message Rejection Details Resolution

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

This rejection has two potential causes: 

Cause # 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.

Note: The Insurance Type indicates why the insured has Medicare as a secondary payer and is required when submitting secondary claims to Medicare.

Cause #2:

The secondary insurance on the patient's case is tied to an Insurance Company that has been set up with a Medicare "Insurance Program" in Kareo but is not. 

Note: Supplemental Medicare plans should be set up as a Medicare Insurance Program 

 

The resolution for this rejection will vary depending on the cause:

Cause #1 - Resolution:

Enter the insurance type code for the secondary Medicare policy

  1. Click Encounters > Track Claim Status.
  2. Look for and double-click on the encounter that needs correcting.
  3. Double-click on the Case.
  4. Double-click on the "Medicare" policy listed as secondary.
  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.

Cause #2 - Resolution:

Update the Insurance Program for the secondary policy

  1. Click Encounters > Track Claim Status.
  2. Look for and double-click on the encounter that needs correcting.
  3. Double-click on the Case.
  4. Double-click on the "Medicare" policy listed as secondary.
  5. Double-click on the Insurance Plan name.
  6. Double-click on the Insurance Company name.
  7. Click the Insurance Program dropdown and select the appropriate option.
  8. Save all the way out (multiple saves required)

Then, rebill and resubmit all affected claims.