Inorder for you to accomplish what you propose you will nned a TPA with the
Medicare contractor(s) that should include what the contractor expects in
NM108 & NM109.
Robert C. Pozniak
NYS Department of Health
HIPAA Practice Group
"Scott Benedict"
<[EMAIL PROTECTED] To: "WEDI SNIP Transactions
Workgroup List" <[EMAIL PROTECTED]>
mcast.net> cc:
Subject: Identifying Medicare as
Corrected Priority Payer
06/03/2003 02:11
PM
Please respond to
"Scott Benedict"
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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on this listserv therefore represent the views of the individual participants, and do
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you wish to receive an official opinion, post your question to the WEDI SNIP Issues
Database at http://snip.wedi.org/tracking/. These listservs should not be used for
commercial marketing purposes or discussion of specific vendor products and services.
They also are not intended to be used as a forum for personal disagreements or
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