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Do you have issues auto-posting Medicaid remits when they are secondary to Medicare?
It appears as if Medicare is forwarding the claim to Medicaid and when Medicaid pays, it is appears Medicaid is processing the claim with the full billed amounts while ignoring what is patient responsibility only (as reported from Medicare).
We are trying to determine if the issue is with the information Medicare is forwarding to Medicaid. For example, the original claim fee was $259. Medicare paid $69.58 and the CO45 was $170.25. There was a sequestration of $1.45. Coinsurance was $17.75.
$17.75 should have been the amount left over for Medicaid to pay. But when Medicaid sends the remit back, they are taking the entire fee amount of $259 and processing the claim as if Medicaid were primary. It is throwing off all the math when you go to auto post the Medicaid remit file.
Posted : August 24, 2017 6:34 am
