BACKGROUND: I am helping a large
payer finalize their 835 transaction functionality. When we receive a claim from a provider that should
have been sent to Medicare (e.g. because we are
the secondary payer), we forward the claim to the
appropriate Medicare intermediary/carrier and let
the provider know that we have done so. Per the IG, we plan to use Claim Adjustment Reason Code B11 and the Corrected
Priority Payer segment to communicate this fact
on the 835.
QUESTION: How should we identify
Medicare as the Corrected Priority Payer in the
relevant NM1 Loop, specifically with respect to data elements 66 (NM108) and 67 (NM109)? Does Medicare have a Federal Tax
ID such that we could use the FI qualifier, or
should we be looking at another qualifier &
code?
Any response (public or direct) would be greatly
appreciated.
Thank
you.
Scott
Benedict
Data Consulting
Group
(248)231-8543
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