Medicaid clients also enrolled in Medicare A&B claims needs I80648543
Answered

Medicaid clients also enrolled in Medicare Parts A & B claims could deny based on prior coverage from Medicare.  LPC therapy is not covered by Medicare A & B, they cover psych testing and some other stuff, but not MA LPC sessions.  So... Medicaid does. So Medicaid claims will get paid by referencing memo #I80648543  (which technically says Medicare EOB is not required to be submitted) .  I don't know where this belongs on the 1500 though. 

 

 

5 comments

  • 1
    Comment actions Permalink
    Avatar
    Gillian

    Hi Andrew, have you contacted Medicare to get clarification on where to add this information? You could add a memo in box 19, selecting the "claim note" option and then entering the memo reference, but Medicare should have the best guidance on where to include this information. 

    Hi Andrew, have you contacted Medicare to get clarification on where to add this information? You could add a memo in box 19, selecting the "claim note" option and then entering the memo reference, but Medicare should have the best guidance on where to include this information. 

  • 0
    Comment actions Permalink
    Avatar
    Andrew Rose

    Thanks Gillian, I will put the memo # in Box 19 for the next claim submission and see how it goes.  Basically they've always denied, and then always pay after I call.  Hoping for that to end... 

     

    Thanks Gillian, I will put the memo # in Box 19 for the next claim submission and see how it goes.  Basically they've always denied, and then always pay after I call.  Hoping for that to end... 

     

  • 0
    Comment actions Permalink
    Avatar
    Andrew Rose

    So I tried to type this into Box 19 

    "refer to  I80648543,  EOB from Medicare not required.  Medicare A & B do not cover LPC 90837"

     

    I got this error in the scrub : 

    It would be nice if there was a character counter or something in fields that have this sort of limit.  That'd be nice. 


    So I tried to type this into Box 19 

    "refer to  I80648543,  EOB from Medicare not required.  Medicare A & B do not cover LPC 90837"

     

    I got this error in the scrub : 

    It would be nice if there was a character counter or something in fields that have this sort of limit.  That'd be nice. 


  • 0
    Comment actions Permalink
    Avatar
    Gillian

    Hi Andrew, is it possible for you to truncate your message to something like "Memo I80648543 - EOB from Medicare not required" to avoid running into this character limit? 

    Hi Andrew, is it possible for you to truncate your message to something like "Memo I80648543 - EOB from Medicare not required" to avoid running into this character limit? 

  • 0
    Comment actions Permalink
    Avatar
    Andrew Rose

    Yes, I did that. Thanks for the suggestion.   

    It's not a simple feature to implement, and it's low priority, and having the scrub error message is fine.  It just would be nice if there was someway to let the user know there's a character limit for character limited fields. 

    Like, can't type any more. or a popup that says "field is limited to 80 characters" or something. 

     

     

    Yes, I did that. Thanks for the suggestion.   

    It's not a simple feature to implement, and it's low priority, and having the scrub error message is fine.  It just would be nice if there was someway to let the user know there's a character limit for character limited fields. 

    Like, can't type any more. or a popup that says "field is limited to 80 characters" or something.